Newsday – Haven Healthcare, Vaccine Distribution, and the Transition of the CIO
January 11, 2021

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January 11, 2021: Sue Schade from StarBridge Advisors joins Bill to break down improving virtual care for elders, the unfortunate demise of Haven Healthcare, and the ever changing role of the CIO. Do they need to be Chief Operator and Innovator too? We’ve had a 9 month head start planning the COVID vaccine distribution. Has the rollout already been botched? There’s much work to do. We have got to get shots in arms. Bottom line. Who’s job is it to “transform” healthcare? The payer or the provider? And what are the juicy details of the Change Healthcare acquisition?  

Key Points:

  • Amazon, Berkshire Hathaway and JPMorgan have pulled the plug on Haven Healthcare. What should we read from this? [00:02:45] 
  • The vaccine can’t be first come first serve. It HAS to be scheduled. [00:14:53] 
  • Optum bought Change healthcare: the $13 billion deal [00:26:05] 
  • The home is the hub for life and care of older adults [00:27:11]
  • The issue of isolation needs attention. Especially during a pandemic. [00:29:10] 
  • How the CIO’s role has evolved to COO by proxy [00:32:06]


Newsday – Haven Healthcare, Vaccine Distribution, and the Transition of the CIO

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Newsday – Haven Healthcare, Vaccine Distribution, and the Transition of the CIO

Episode 350: Transcript – January 11, 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. Today, Havens End, Optum grows, vaccine distribution, CIO role for 2021 and beyond and caring for our aging community. We hope to get at all those stories. We will see we’ll see how well we do. My name is Bill Russell, former healthcare CIO for a 16 hospital system and creator of this This Week in Health IT. A channel dedicated to keeping health IT staff current and engaged special thanks to health [00:00:30] lyrics. Who’s our new state sponsor. That’s my company. And I do executive coaching for CIOs. If you’re interested in that checkout and, if you want to be a part of our mission and become a show sponsor, send an email to [email protected] a quick note, we launched a new podcast, Today in Health IT. Where we look at one new story every weekday morning, check it out. Subscribe wherever you listen to podcasts. All right, today we introduce one of our recurring guests for our Newsday show, the [00:01:00] sushi former CIO of the year. I love that title and a principal at starboard advisors, a health it advisory firm.

[00:01:06]Good morning, Sue. Welcome to the show. 

[00:01:09] Sue Schade: [00:01:09] Morning. Thanks for having me looking forward to this. 

[00:01:12] Bill Russell: [00:01:12] Yeah. I’m looking forward to it. Yeah. Happy new year to you as well. Did you have a good break? You feel like you’re wrestling ready to go? 

[00:01:19] Sue Schade: [00:01:19] I did took the week off between Christmas and new years and tried to relax, 

[00:01:25] Bill Russell: [00:01:25] You know it’s interesting. I’ve worked. We’re always out of our house. And being at home [00:01:30] used to be like, eh, I’m away from work, but it’s not that anymore. Do you find it? Find it hard or did you leave your home? 

[00:01:37] Sue Schade: [00:01:37] We left our home to do errands and to take gifts to kids and with masks on stay a short while and open them and come home.

[00:01:45] But yeah we stick close to home and My husband’s retired. So he said, if you have trouble relaxing, just, you know, follow me around. I’ll 

[00:01:53] Bill Russell: [00:01:53] Follow my lead. When I sleep, you sleep. And you’re like you’re sleeping at two o’clock in the afternoon. It’s like, yeah that’s what we [00:02:00] do when we’re retired. No, that’s fantastic. All right. So you’ve been a guest on the show before, but this is a little different, you and I are just going to go back and forth on some news stories. And what we’re trying to do the goal is really to provide health IT staff with some context on the new stories and try to frame it through a health it lens and you know, just see where it goes.

[00:02:19] So I’ll kick us off with the first story, and then we’ll just go back and forth. The first story, I think probably the biggest story of the week. It’s hard to say what the biggest story of the week is. Obviously there’s a [00:02:30] big story in the nation’s capital and we’re not gonna hit all that cause there’s- there is not a health IT application, but the biggest news stories in health IT, gosh it’s hard to say. I mean, you have so much going on Havens End those probably the one that got the biggest press and that is, here’s a little excerpt from the wall street journal, and that is a healthcare venture launched by with great fanfare by three of the world’s most prominent companies, Amazon Berkshire Hathaway, and JP Morgan and company.

[00:02:58] And their chief [00:03:00] executive is folding about three years after founding Ede health sparked by an idea of JP Morgan, chief executive, Jamie diamond, and supported by Amazon ship Bezos and Warren buffet sought to transform healthcare and reduce costs for hundreds of thousands of workers at three companies by pulling their resources and technology.

[00:03:18]That was not only what they were talking about. They were also talking about, Hey, we’re going to do this for us. And then we’re going to take this out to the market. So there was a lot of excitement around this. And it’s come to an end [00:03:30] three years later. You know, I’ll let you get to the first comment on this and we’re actually going to go to our LinkedIn posts as well and get some comments from there. What’s your takeaway from this event? 

[00:03:39] Sue Schade: [00:03:39] So yeah, big story of the week in healthcare, at least the I was never probably as optimistic about this organization and what it could do as you may have been. I remember reading and hearing what you had to say three years ago. Healthcare is complex.

[00:03:56] As we know, to quote someone who said, who knew it was so complex. Right? [00:04:00] And some of the stuff I’ve read since Haven is ending talked about silos and we know in healthcare silos don’t work. They just don’t . I was optim- I wanted to be optimistic. And when Atul Gawande was named to head things up, I have incredible respect for him.

[00:04:16] I think he is quite a visionary as well as very practical in terms of the challenges of healthcare. But it just, you know, they didn’t. They didn’t make it. They didn’t get too far. They did some pilots, apparently themselves. I think [00:04:30] that can he, as long as they did to name, it probably was a bad omen. So it’s, I wasn’t that optimistic. I am disappointed that it didn’t go somewhere and it certainly reaffirms it. The silo activity doesn’t work. 

[00:04:43] Bill Russell: [00:04:43] Yeah it’s interesting some of the comments on LinkedIn and if you want to comment on this every day, I post some of these stories and open it up for discussion now.

[00:04:52] And you just follow me on Bill J Russell on LinkedIn. This is from Dan Howard and Dan is a CIO [00:05:00] and. He made the comment that let’s see, where does it start? Here? It is. I was excited about the potential of Haven to disrupt and move the needle. But in reading some of the fallout some of the fallout information, it’s not too surprising.

[00:05:13] It’s almost it’s a health- man. I can’t read today. Sorry. I need my glasses. I think some of the fallout information. And it’s not too surprising. It almost seems like they were more of a healthcare think tank rather than an operational unit that worked cohesively. And I, you know, that [00:05:30] whole idea of silos, I think really drives us home.

[00:05:32] And you you made that point. I  that we, there were times where like, you would see Amazon came out with their new program for their employees. And I asked somebody from Amazon, I’m like, so is this part of Haven? They’re like, Oh no, not really. This is such as something we’re doing on our own. And I thought, well, that’s interesting.

[00:05:49] That’s almost what we expected Haven to do. And then they did something else around pharmacy and I’m like, so is this in the Haven thing? They’re like, Oh no, this is something else we’re doing. You start to scratch your head and [00:06:00] go okay. What exactly is Haven and what are they doing? And I think he’s, he captures it in that whole think tank comment that’s really what they ended up doing.

[00:06:10]I t’s kind of disappointing. I agree with you that  was, it was a good pick and I thought he was going to take it in a good direction. But I think what you saw there is you take three, the cultures of three very distinct companies, very large companies, and you try to satisfy too many masters there and they just weren’t [00:06:30] able to all get on the same page.

[00:06:31] So that’s, I guess it’s not overly surprising that ended the way it did any implications for health it on this. I mean, should we read too much into this that, you know, healthcare change is going to have to come from the provider or the payer? Is that what we should read into this? What should we read into it in terms of where change is going to come from?

[00:06:50] Sue Schade: [00:06:50] You know, that’s a great question Bill, because if you look at the ecosystem in terms of health care, you’ve got the government, obviously that plays a role. You’ve got providers, [00:07:00] which are delivering health care and you’ve got, you know, payers in terms of insurers. And then you’ve got everybody in the supply chain in that ecosystem who is in providing some kind of product or services within the healthcare delivery.

[00:07:13] And then you’ve got you know, in this case it was huge employers, right? Who wanted to make a difference and make changes your organizations, and then roll it out. So really they all have to come. They all have to come into play all of those parts of the healthcare ecosystem. [00:07:30] And you know, having spent most of my healthcare IT career in a provider organization, I put providers who are actually delivering the care to the patients as a, you know, really front and center in that.

[00:07:42] Bill Russell: [00:07:42] Yeah, absolutely. All right. So I have stories to get through where which way do you want to go? Do you wanna talk about the COVID vaccine distribution? You want to talk about the changing role of the CIO?  Where would you like to go next? 

[00:07:53] Sue Schade: [00:07:53] Let’s talk about the vaccine. I think it’s the most interesting story. And it’s there was, I thought about it in advance [00:08:00] trying to tease out what’s relevant news versus our opinion. And I know you have a mix on this show. 

[00:08:07] Bill Russell: [00:08:07] Yeah, no, absolutely. Well, part of it is us trying to provide context to it. And so that. Gosh, man. I read articles where doctors don’t know where to go to get the vaccine.

[00:08:18] And then I read articles where, you know we’re trending in the right direction and we’re heading towards a million you know, a million vaccine. I’m going to get this number wrong million a week, millions day [00:08:30] million a day. Yeah. We’re so we’re heading in that direction. Is. Is what we’re seeing, but we’re also seeing, it’s just exposing a lot of vulnerabilities, a lot of things that we don’t do well between public private and and this is really flexing a lot of new muscles. So what specifically are you reading or hearing about in terms of the vaccine distribution? 

[00:08:53] Sue Schade: [00:08:53] Well, let me go from great optimism- this is January, early January- over a [00:09:00] month ago. Prior to the, the first vaccine in an arm to what’s really happening now. And my great optimism a month ago, I listened to a podcast.

[00:09:09]You know, I’m a fan of Andy Slavitt’s “In the Bubble” podcast. I bounced between yours and his on my daily walks.  Not each walk, but did, and he had a excellent podcast on vaccines. A senior person in CVS. And another expert physician. I can’t remember exactly [00:09:30] his role.  And when the CVS person talked about, we have 10,000 distribution points right around the country, assume Walgreens has some similar number.

[00:09:41]Don’t quote me on this, but I thought he said we have a hundred thousand people to put, you know, vaccines in arms. And the app they had ready for scheduling reminders for the second dose, everything else I’m like, okay, this is good. This is, you know, widespread to the general public when it’s [00:10:00] our turn.

[00:10:01]What’s happened seems far different than that. I haven’t seen in the news yet what they’ve been able to do and stand up. It’s gonna, you know, I, if it’s okay, you can bleep it out later, but it just seems to me that it’s a bit of a cluster in the way that testing was a cluster nationally. And there’s a huge dependence on the States and the public health infrastructure, which is extremely taxed.

[00:10:25] And I think it exposes so many holes. I know you in the [00:10:30] article that you shared , it highlighted a couple key things in terms of it, but it exposes holes in our logistics. Our ability to provide the staff , track the data. You know, this is where a country that’s got a national health system is probably going to do far better in terms of getting shots in arms at the scale that’s needed.

[00:10:52] Bill Russell: [00:10:52] Yeah. I mean the article I highlighted talked about some of the IT data challenges, and this was from the Harvard business review and they talked about four steps that [00:11:00] must be taken standardized the way personal health data is exchanged align States, immunization registries, and state, and federal reporting analytics, design, immunization passports that are portable, equitable and protect privacy and address privacy portability in cybersecurity trade-offs.

[00:11:16] I highlighted that, that was one of the stories I highlighted early in the week. One of the things I highlighted later in the week was. I received an email and the email was from my homeowners association and I was kind of surprised that was the mechanism that was used, [00:11:30] but the local health system that has the vaccine, and this is one of the things that’s a challenge, not every health system got the vaccine in every market.

[00:11:38] In fact a single health system was chosen. So if you’re a provider with another health system, you might be sitting there saying, Hey, my health system doesn’t have the vaccine, but in reality, You could go to the other health system as a frontline care worker and get the vaccine. That is part of what they are supposed to be doing is communicating within that market that, Hey the [00:12:00] vaccine came to this health system for the entire community and the care workers are first in line.

[00:12:05] Absolutely the case. And in second. Is I think people over the age of 65, that’s the, according to this email I got was, Hey, these are the, at least in the market that I’m in. And this is part of the challenge, right? It’s market specific. So the health system and our market did a great job of communication.

[00:12:24] They set up locations, they set up scheduling . They got the email out there. They utilize [00:12:30] distribution lists that maybe are not normal for health systems to use. Like. My my homeowners associations you know, list. And I think they did a good job in getting the information out there. So it’s an interesting when I read some of these other articles and I go, wow, you know how can it be that in this community with a fairly small health system?

[00:12:49] I mean, I’m talking about a health system. That’s probably the, you know, teetering a little lower than a billion dollars a year. So not a ton of resources. They even don’t have a CIO. They have [00:13:00] IT, a director of IT, who is- who acts as the CIO. I mean, we’re not talking a major health system, but I look at the logistics that they put together and it’s spot on.

[00:13:10] Okay. So if you go into other markets, if you go into like a North Carolina and you give it to Atrium and you go into Seattle and you give it to a Providence, I would suspect that they have, that they should have the resources to really wire that better, or just the scale of it is that much harder to overcome? What are your thoughts around [00:13:30] it? 

[00:13:30] Sue Schade: [00:13:30] So I think that’s a good point because, and you just named two leading organizations, atrium and Providence, and this probably many others across the country, that if they were somehow responsible for the broad, broader distribution than just their own frontline workers and employees, that could be a positive thing.

[00:13:48] Maybe them partnering with these huge pharmacy chains, right. Which from a logistics and geography perspective. Everybody lives within some short [00:14:00] distance of one of those probably right. One of those pharmacies . You know, but it’s right now it’s up to the States. The States had to submit a plan.

[00:14:09]The States can interpret the CDC guidelines or apply the CDC guidelines in terms of the groups. So, you know, you said where you are, it’s over 65, but they’re broken down into other groups over 75 and then 65 to 75. , you know, a couple anecdotes, just how the States are dealing with it. We saw where you are in Florida, very long lines, [00:14:30] right.

[00:14:30] And very elders out overnight waiting in line and their cars are on the sidewalk. So that doesn’t sound like a very workabl 

[00:14:42] Bill Russell: [00:14:42] And you know, what’s interesting about that in my email. It said you will you’ll schedule it. There’s a time. There is no lines. In fact, I said there will be no line. So I, you know it’s interesting.

[00:14:53] Sue Schade: [00:14:53] Yeah, it can’t be first come first serve. I mean, to line up, it has to be scheduled. So I [00:15:00] talked to I talked to my sister from I’m from Minnesota and my family’s all there. I talked to her yesterday. She worked in public health department for  many years in a leadership role. And she said it’s clear what the groups are, but not the execution at this point.

[00:15:13]In Minnesota, she’s retired now. So she was going to send a letter to her colleagues in the public health department saying, what’s up here. This doesn’t seem to be getting executed. Well, she told me about in-laws in New Mexico. All they had to do was sign on to go [00:15:30] online, get into a registry, give their birth date.

[00:15:34]They’re probably in their sixties and they got an appointment. Right. And you know, so it’s all over the place in Rhode Island where I am. I keep checking Rhode There’s some broad sense about the groups, but still no information about execution. So to speak beyond, you know, the frontline workers at the hospital. So. 

[00:15:56] Bill Russell: [00:15:56] Yeah, it needs a lot of work. [00:16:00] So here’s the interesting thing to me is I mean, there’s so many interesting things here. First of all, I have no patience for political hacks. I just don’t from either side, quite frankly, I don’t have a patience. For the people who are taking potshots at the New York governor.

[00:16:12] And I don’t know patients from the people taking potshots at the Florida governor because we have a job to do here and that’s to get the vaccine out to everybody that we can get it out to. And at the end of the day, what this comes down to is the governors have looked out and their plan is okay, we’re going to get into the hands of the health system.

[00:16:28] So let’s look at, let’s look [00:16:30] internally at us. What do we need to do? First of all, we need a good communication plan. And one of the challenges I’ve found with a lot of health systems and I is that the marketing arms are still maturing and it used to be that, you know, marketing was just, you know, by the baseball stadium of moniker.

[00:16:50] And you did your job for the year. You had brand awareness. Well, this. The pandemic changed everything. And it’s like, all right, we had to get information out on. [00:17:00] How do you what does COVID-19 mean? What does it mean for our community? You know, what is a social distancing? This was a new term for us back in March.

[00:17:10] We didn’t really know what it meant. What does mass square? I mean, this was all these things that people were looking out. And I guess you could look at Google, but a lot of them were saying, look, I’m going to go talk to my doctor. I’m going to talk to my health system. And so that a lot of that really stems from obviously operational teams coming together and saying, what do we need to communicate?

[00:17:28] But then it’s handed to the [00:17:30] marketing group to say, okay, get this out into our community, get it out through you know, get us on the news, get us in social media channels, get us, get this information out. And a lot of health systems were sort of trying to build this as they went. All right. Well, this is the final exam.

[00:17:47] The final exam is, Hey, we’ve been doing this now for the better part of nine months, almost a year. And the final exam is all right, let’s let everyone know how to get the vaccine, where to get the vaccine. [00:18:00] You know what the differences are in the vaccines, what a two dose regimen is, get this information out and you know, from what I can tell.

[00:18:09] And the community I live in it’s pretty well wired. It looks pretty good to me. It has a scheduling program. Now, one of the, one of the things that we’ve talked about was the scheduling they’re using is Eventbrite. And I’m like, okay, I understand the security problems with it. But if you asked me to put together a scheduling program and [00:18:30] I couldn’t use my portal, because this is not only for my health system, but for the other health systems in our community, Then I’m going to look to the cloud and it’s either going to be Eventbrite or Calendly or it’s going to be something like that.

[00:18:42] So so at the end of the day, that’s the way they went and it looks wired, but then I read these other stories and I’m going. Wow. Th this really I buy it, but I’m not sure I’m blaming the governors. I’m saying if they’ve passed this down to the health systems, we need to look at the health system in those local markets.

[00:19:00] [00:18:59] We’ve got the vaccine and evaluate, were they the right people to get the vaccine because they don’t know how to communicate with the community, to put the process in place, to communicate with the other health systems and to set up the logistics, to have this done. Yeah. I mean, I think there needs to be some accountability and I hate to be the one taking Pell systems out to the woodshed.

[00:19:21] Cause it’s been a. It’s been a significant challenge, but we knew this day of delivering the vaccine was coming. We should have been [00:19:30] ready for it. 

[00:19:31] Sue Schade: [00:19:31] I totally agree with you that we knew this day was coming and we should have been ready at the same time if there had not been a pandemic and everybody said, we need a really good, smooth well-orchestrated flu shot the month of November 21 for everybody. Right. And we can plan for it. That could probably happen in a better way because [00:20:00] The resources and people who have had to focus on let’s make sure the vaccine distribution and shots in arms go as well, have been very focused on testing and training.

[00:20:12] Right? So everybody involved in this is very taxed. So additional resources where do additional resources come from. So, but I agree with you that. That planning should have been happening. And if you think about it, there’s, you know, what are the delivery mechanisms at this point? There’s provider [00:20:30] organizations.

[00:20:30] And should I be able to go to my provider organization portal online and say, ask the question and find out when. When as a patient within that system, could I possibly get it through my PCP? If that’s an Avenue, should I be able to go in my case, it’s Walgreens where I get my flu shot. Should I be able to go online at Walgreens and say, that’s my Walgreens on main street in Providence.

[00:20:54] When can I get my flu shot, but my vaccine or should I be able to go on Rhode [00:21:00] and S and find out where’s mass distribution for vaccine happening in some parking lot, somewhere, or some convention center, right? I mean, you talk about the push in your community and your story about the email and the homeowners association, but there’s also the pull, because at this point, doesn’t everybody.

[00:21:18] Who believes in science and trusts it, want to get a vaccine. So we’ll go find the information and get it done when it’s our turn. 

[00:21:27] Bill Russell: [00:21:27] Yeah, I agree. I’m going to hit some of these comments [00:21:30] here. I know that some of my regular listeners actually worked for state governments and they’ll give me a call on this, but I think the States have fallen out down as well.

[00:21:38] Now my, my local County than my state, actually, I, and I know Florida takes heat because it’s a Republican state. And it takes heat from the other side as New York takes it from the Republican side. But at the end of the day, I can go to the Florida website. I have tons of information. I can go to the County website and there’s tons of information that tell me what to do.

[00:21:58] It would be interesting [00:22:00] that I’d be curious right now. If I had a staff to do this, I would, I’d send them to all 50 States because you know, 25 to 30% of their traffic on their website today is people trying to figure out the vaccine. So I would think there would be a banner on the state website and says, if you are looking for the vaccine and how to get the vaccine and what our guidelines are for our state, click this button. And it would be interesting to see how many of the 50 States are even remotely close to that. 

[00:22:29] Sue Schade: [00:22:29] Yup. [00:22:30] Cause I just went to r it was two or three clicks before I got to the COVID-19 vaccine. And it’s saying final decisions have not been made about who can get vaccinated at each phase, which seems to me, I don’t know why that is.

[00:22:47] This should have been done by now. And  if the decisions haven’t been made about when. Then I assume the decisions about where and how it’s not the maybe there, and it’s disappointing because Rhode Island did a really good job on testing and [00:23:00] really led the way in numbers of testing. So I was optimistic about the vaccine, you know organization, but yeah, I, you know, I’m not gonna, I’m not gonna throw blame on any one place or person or role. We can do better. We need to do better. 

[00:23:15] Bill Russell: [00:23:15] Yeah. And I’m throwing a bunch of blame around just only because it feels to me like we had a nine month head start and we could have it’s not hard to section off a group of people and say, and it doesn’t even have to be, you know, physician in frontline care workers are caring for [00:23:30] people. They’re doing testing. I get that. But you have administrative staff, you could have taken a, your population, health person, your somebody from it, somebody from marketing, whatever, put them in a room and said, look, A day’s coming when we’re going to get a vaccine, it’s not going to be in huge supply on the first day.

[00:23:45] So we’re going to have some limitations. We want different options for you. I, this is what our CEO of my last health system would have done. I just know it Fred Dempster made a comment. This has been made more challenging by governors and related. Micro-managing the data [00:24:00] infrastructure in a maturity model is, or just above feeble And I think. You know, that’s how people feel about the state. I have talked to some CIOs who have struggled with the state in terms of the reporting requirements and things they’ve been asked to list Lucian Dr. Lucianne, I who’s been a guest on the show with Rimedy She says the two dose requirement with different timeline per manufacturer makes us even more complex, especially when we don’t have a good track record of, two dose vaccines in the adults, in the U S and then she talks about how they’re helping. [00:24:30]

[00:24:30] To bring people back for that second dose. And that is a, that’s, you know, we have enough trouble, as you mentioned with the flu vaccine, and this is a two dose regimen. And if you don’t get the second, you might as well not get the first. So it’s it’s  and direction, I’ve talked about this in some cases, what they’re doing is they’re just handing people a card that says on this state come back and people are putting that in their wallet.

[00:24:52]That’s the point? That’s the point we’re at this is this is going to be interesting for us, do you think this is being tracked in the [00:25:00] EHR? We think that’s how we’re tracking this. 

[00:25:01] Sue Schade: [00:25:01] Oh, I would assume. Yeah. Well so again, it, well, if you’re a hospital employee it’s probably being tracked through OC health and you know, the separation for employees between the OC health database and your EMR if you’re getting it, if you’re getting it through your provider, it’s being tracked in the EMR.

[00:25:16] If I eventually go up and go to Walgreens or CVS and get it, then they’re just going to have it in their system. And I’m going to have to tell my doctor, right, that I got the vaccine. So, and I, if it’s at some mass [00:25:30] vaccine place set up at a convention center by the state, I don’t know how it’s going to get where it’s going to get tracked. 

[00:25:38] Bill Russell: [00:25:38] Yeah, well, CBS is going to put it in. It’s going to put it into Epic and that’ll be interesting to see where we build the register. 

[00:25:45] Sue Schade: [00:25:45] Yeah. What’d you say? 

[00:25:47] Bill Russell: [00:25:47] Well, CVS has Epic, so they’ll probably put it in there. So. Yeah. All right. Let’s 

[00:25:56] Sue Schade: [00:25:56] You and I aren’t going to solve it. There’s much work to do, and we got to get shots in arms. [00:26:00] Bottom line. 

[00:26:01] Bill Russell: [00:26:01] Yeah, it has. It’s usually the case. We’ve spent a lot of time on the first two stories. I just quickly want to touch on Optum bought Change healthcare, a $13 billion deal. And you know United health group just keeps getting bigger as the $250 billion company. And you know, if they’re in your market, they just created some they just acquired some new capabilities.

[00:26:20] They continue to grow out their health network. So it’ll be interesting to keep an eye on the people that are sort of positioning to be the national delivery arms, United healthcare [00:26:30] being one of them.  Walmart is actually trying to position to be one of them moving forward. You know, there’s others and there’s large players, obviously, you know, essentially you have gosh, ACA and others, which are large but they don’t necessarily have all the capabilities that you see in a United health group in terms of their payer capabilities, their technology mix and those kinds of things.

[00:26:51] So it’ll be interesting to keep an eye on them. I want you to tee up one of your stories. So which story would you like to tee up. 

[00:26:57] Sue Schade: [00:26:57] Am only going to get one? 

[00:26:59] Bill Russell: [00:26:59] Well [00:27:00] start with one. We’ll see where it goes. 

[00:27:01] Sue Schade: [00:27:01] Okay. Yeah, just in terms of the timing well, let me go to the one that’s introducing, I think, a good resource to your listeners.

[00:27:11]The article is for older adults, the home is becoming the hub for life and care. And this is by Jane Sarah Sone-Con. She also writes a she really deals at the intersection of healthcare and economics and has a popular blog called health [00:27:30] populi does a lot of research in this space.

[00:27:32] And in this article, she highlighted research report by Lori. O ive l called the future of remote care technology and older adults connection is everything I didn’t, I’ve pulled up the report after reading Jane’s article, but didn’t get through the 25 pages of it. But it’s interesting here in terms of what’s happened with virtual care for elders.

[00:27:56] And in that article, she talks about telemedicine [00:28:00] unreadiness. She talked about a number of options to connect older disconnected health consumers, including leveraging their televisions the voice tech digital assistants like Amazon Alexa , adapting, FaceTime, and Skype type calls. She also talks about for people over 65 who experienced a virtual care visit during the pandemic,  just how those numbers on a number of metrics. We’re so much higher than they would have been in 19 in terms of their interest in their adoption. 

[00:28:28] So that [00:28:30] is worth looking at and she closes on while we’re still in the midst of battling the coronavirus, which is hitting older people in America especially hard or a lot of support gives us a hopeful roadmap to rebuilding care and a better, safer, more cost-effective humane setting our homes.

[00:28:46] Bill Russell: [00:28:46] Yup. 

[00:28:46] Sue Schade: [00:28:46] Many building blocks to the technologies and applications are available now, analytics and virtual reality and augmented reality are evolving, spurred on by the public health crisis. So I will, at some point read the full report. I’m definitely interested in this [00:29:00] area, but I’m wanting to share that much. What were your thoughts on that? 

[00:29:05] Bill Russell: [00:29:05] I appreciate you sharing this resource. I did. I scanned the report and there’s a couple things that jumped out. They talk about loneliness and isolation, which I think is an epidemic in America, not only among the aging population, but also quite frankly, I just think it’s an epidemic in general.

[00:29:19] I run into people all the time. And just have, try to have conversations and, you know, figure out who their net is. The people that you talk to when they have a challenge or a [00:29:30] problem. And a lot of people just do not have that the older they get. And you’re just surprised that the fact that they don’t have best friends and they don’t have friends.

[00:29:39] And you’re just sort of, you know, in this epidemic, this pandemic did not help that in any way. She has some numbers, October, 2018. 34% felt a lack of companionship in June of 20, 20, 41%, 27% felt isolated from others in October of 2018, 56%. In June [00:30:00] of this year 28% had infrequent social contact, 46% this year.

[00:30:05] And, you know that’s the situation my parents are living through right now. They are they’re pretty well isolated. They are being good citizens. They are taking care of themselves. They you know, did Christmas and via via it wasn’t Skype is, it was probably a Zoom if I thought about it And, you know, all those things are hard for them.

[00:30:25] They did not go to the place they normally do. And anyway, w when you’re [00:30:30] talking about the aging, that’s one of the things, all right. So we connect them through digital and she this research, that’s a great job and sort of pointing out some of the challenges we had bringing that population in.

[00:30:41] And it was as you mentioned, you know, the fact that in some areas, the bandwidth just wasn’t there in some areas it’s training and helping them to make those connections. You know the reality is during the pandemic that the policy foundation was changing as we went along. So how systems were adapting [00:31:00] and, you know, we just didn’t have things that were that easy that they were used to. And I really love this research. I mean, it talks about this growing what they call elder orphans that reads the even greater risk of isolation. This is a really good report. I’ll probably post this in some way in the show notes so people can reference it.

[00:31:22] Sue Schade: [00:31:22] It’s really good. Excellent. Good. I’m glad you picked up on the loneliness part of it. I don’t know if you were at the chime forum [00:31:30] couple years ago, when did back Murphy? Yeah was talked about that. That was an incredibly powerful talk. He’s got a book. I don’t know if you know the name of the book, he’s he focused on this in terms of loneliness and as we know, he’s nominated to be the next us surgeon general again. But  this issue needs attention. Absolutely. 

[00:31:53] Bill Russell: [00:31:53] Well, let’s touch on your last article. So your last article is interesting and we’ll continue to hit on this throughout the year. [00:32:00] Okay. You know, the CIO role is changing. So what what do we expect in 2021 and beyond? Yeah. 

[00:32:06] Sue Schade: [00:32:06] So this article this was in Becker’s. The CIO’s transformational role. Three execs share how the position has evolved to “COO by proxy.” And it there’s a Gartner reference here by 2024, one quarter of CEOs working in large traditional enterprises are expected to become the CFO COO by proxy. Oversee operational responsibilities, [00:32:30] including recommending enterprise digital projects for approval decide which activities to fund.

[00:32:34] And those that should be done. Continuing, according to research and advisory firm, Gartner annual report on healthcare. You know, I always thought When I was a CIO everybody reported to the CEO. I thought if you can’t report to the CEO, which is okay, you want to report to the COO because COO has the broadest view across the organization of every component and what do CIO’s [00:33:00] need to do? They need to be across the whole organization with a broad view and support all of those. Right. As well as looking ahead. So I see that connection between the CIO and the COO. I can see the CIO is taking on far more operational responsibility. I think that they have stepped up and kudos to them.

[00:33:16] I am an awe during the pandemic to take on a broader role and really deal with a lot of logistics and operational issues. So I think you see evolution there. I think you’ll see evolution in terms of more [00:33:30] CIO is becoming what some have called the double CIO. Chief information, officer, the chief innovation officer, the chief information officer and the chief digital officer, I think expanded role, no question.

[00:33:42] And all, depending on the organization, depending on the individual in terms of their aspirations where they want to focus and where they can do the best for the organization. 

[00:33:53] Bill Russell: [00:33:53] Yeah. You know it’s It’s interesting. Just a couple of examples to close that out. I read an article where, and again, I’ll [00:34:00] ask him when he comes on the show. It appears to the Providence CIO is also in charge of all real estate. That’s interesting to me. Chad, Brisendine actually at St. Luke’s in Pennsylvania, took on frontline revenue responsibility. He’s in charge of actually the entire service line around radiology and imaging. As a part of his role.

[00:34:19] So he actually took on a revenue line and those kinds of things. So that’s interesting. Sheesh trachea was just hired away from Mount Sinai to UC [00:34:30] Davis. And he’s going to have  the dual role, the CIO role.  Gosh, I’m trying to think. There’s a couple of examples of that’s going on.

[00:34:39] So I think that’s one of the things that’s going to happen this year is we’re going to see dual role roles either towards an operator, a dual operational role, or a dual. Innovation role. And I agree with you. This is going to be this will be the year that more things can you imagine more things getting put on the CIO [00:35:00] at this point?

[00:35:01] Sue Schade: [00:35:01] Yeah. So two things that along those lines, I think about it. I think that maybe this is your being that year cost is going to be a driver. And it made me think about it just kind of been I don’t want to call it title inflation, but you read about so many new cheeks within organizations and can organizations afford that many people at that senior salary level, or will there be some consolidation of roles?

[00:35:28] Right. So I think that’s one [00:35:30] factor. The other, when you say, can you imagine taking on more, you know, this is where you and I share the commitment next generation leaders. This is where that leadership level under the CIO, whatever the CIO is, broad role expanded role, maybe. Is so critical if you don’t have those strong people leading in their areas, then no, you can’t take on more.

[00:35:54]Bill Russell: [00:35:54] And I’m reminded of a conversation I had with Stephanie Reel and she was talking about her organization and I think the, I, [00:36:00] her successor will probably come out of her team because she had such a great team underneath her of about six people that were direct reports that were running large parts of the it organization.

[00:36:12] And that’s what it looks like. I think we are seeing more CEOs elevate from within the ranks when those positions become available, it just makes sense. 

[00:36:22] Sue Schade: [00:36:22] Yeah, I’ve been tracking that every time I see some kind of movement CIO is moving around. And oftentimes to say second in command, [00:36:30] whether that’s a good way to put it or not is pulled up to run things. And in many cases they are then becoming the permanency CIO. So that’s, you know, that’s great. That’s great that people are being developed and moved up. 

[00:36:43] Bill Russell: [00:36:43] Yup. Absolutely. Well, that’s what we saw at Cleveland clinic. I think we’ll see that in other places. Sue, thank you very much.  We will get better at this.

[00:36:50] This was, you know we tried to cover five stories. I think what we learned in this, we can only cover four stories. So we’ll you know, we’re getting a little better. But you know, that’s all for this week. If you know [00:37:00] someone that might benefit from our channel, please forward them a note. They can subscribe on the website. or wherever you listen to podcasts. We want to thank our channel sponsors who are investing in our mission to develop the next generation of health IT leaders VMware, Hill-Rom and Starbridge Advisors. We have a new schedule for our podcast of 2021. Monday is news. Wednesday is influence our solution showcase and Fridays the influence. So be sure to check back from it more. Great content. Thanks for listening. That’s all for now. [00:37:30]

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