September 20, 2021: Sue Schade from StarBridge Advisors joins Bill for the news. How can we be more productive in health IT? Where are the pain points? What tools can we bring to bear? How can we engage patients that have delayed care? McKinsey survey reveals U.S. hospital patient volumes have moved back towards 2019 levels. Wall Street Journal reports that remote work may now last for two years, worrying some bosses. Another big conversation is the rework of the labor pool. And is healthcare too hard for Big Tech firms? Some say, if companies misunderstand evidence-based medicine, they have no business bringing technology into medicine at all. And when it comes to the countless disruptive technological innovations that have been flooding the medical field the last couple of years, the essence of this change is not technological it seems, but rather cultural.
Newsday – Patient Volumes, Remote Work, and Big Tech in Healthcare
Episode 445: Transcript – September 20, 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: Today on This Week in Health IT.
[00:00:01] Sue Schade: I continue to be concerned about IT direct support and engagement with our clinical users. That is very difficult in the remote world. I think that IT organizations need to find ways to accommodate that and structure it. And not assume that it can all be done remotely.
[00:00:23] Bill Russell: It’s news [00:00:30] day. My name is Bill Russell. I’m a former CIO for a 16 hospital system and creator of This Week in health IT. A channel dedicated to keeping health IT staff current and engaged.
[00:00:39] Special thanks to Sirius Healthcare, Health Lyrics and World Wide Technology who are our Newsday show sponsors for investing in our mission to develop the next generation of health IT leaders.
[00:00:48] Just a quick note, before we get to our show, we launched a new podcast Today in Health IT. We look at one story every weekday morning and we break it down from a health IT perspective. You can subscribe [00:01:00] wherever you listen to podcasts. Apple, Google, Spotify, Stitcher, Overcast. You name it, we’re out there. You can also go to todayinhealthit.com. And now onto today’s show.
[00:01:12] Today it is Newsday and Sue Schade is in the house. Sue, welcome back to the show.
[00:01:18] Sue Schade: Happy to be here.
[00:01:19] Bill Russell: I’m looking forward to the conversation. We’ve picked a four stories that I think are pretty relevant. We’re going to take a look at remote work. It’s interesting because remote work is one of those things that we [00:01:30] thought by now, we’d be going back to the office, but a lot of plans have been delayed and we’ll see where that goes. We’re going to talk big tech in healthcare. That’s been a hot topic over the last couple of weeks with Google’s reorg and how that has gone down.
[00:01:45] We’re also going to look at volumes and how volumes are being impacted and a survey around that. I’m going to let you choose which topic would you like to start with?
[00:01:55] Sue Schade: Oh, you know which topic I want to start with? [00:02:00] We can you, you missed one, you said four and you only mentioned three
[00:02:05] Bill Russell: Around digital health, cultural transformation.
[00:02:08] Sue Schade: Yeah. Let’s start with patient volume. Let’s go in order of the ones I said, let’s talk about it, but I’m going to let you tee them up. Cause you’re more familiar with the stories. Okay.
[00:02:18] Bill Russell: All right. McKinsey did a survey. Patient volumes reportedly moving back to 2019 levels. McKinsey company, a global management consulting firm went out, interviewed a hundred private sector [00:02:30] hospitals across the United States in late July to examine how COVID-19 continued to impact hospital volumes, emergency department and inpatient volumes.
[00:02:39] And what they found is they’re returning to 2019 levels. That’s not uniform across the entire country, but that is roughly where we’re heading with respondents, noting that they expect it to be roughly five to 6% higher in 2022. Outpatient and procedural volumes were 3 to 4% above [00:03:00]2019 levels in July and are expected to be six to 8% higher in 2022 further more than, and they have a whole bunch of great stats in this thing.
[00:03:10] More than a third of provider respondents said they expected patient demand to exceed capacity in psychiatry and orthopedic surgery in the next six months, roughly a fourth said they expect the same. Challenged in cardiology and gastroenterology plastic surgery and [00:03:30]ophthalmology continue to have large decreases in outpatient volume when compared to 2019 to address these challenges more than 50% of hospital respondents said they would expand their clinic hours to increase outpatient access.
[00:03:46] Other providers response include hiring more physicians, increasing physician productivity, expectations, hiring more clinician support staff, increasing marketing to patients and proactively [00:04:00] calling patients who have delayed care. Some COVID-19 related challenges, however, remain including. A big caveat, including shortages of nurses and clinical support staff and some patients continuing to delay care.
[00:04:15] And then they have a whole bunch of stats in there. When I read these things, it’s, there’s things working against each other here, right? We have some areas where the demand is pretty high, but we still do have the shortages of nurses, the shortages of clinical staff.[00:04:30]
[00:04:30] And when I think about those things, when they come to the CIO, when the health IT organization is engaged in these conversations what does that conversation look like? Do you think?
[00:04:41] Sue Schade: With the CIO? That’s an interesting question. Cause I was going to talk about it more broadly from a health.
[00:04:47] Bill Russell: Sure. Yeah. Let’s start there. And then we’ll, we’ll dive down into that.
[00:04:51] Sue Schade: Sure. Sure. So there are competing issues here and I was happy to hear in this article healthcare providers trying to make [00:05:00] proactive calls to people who have delayed care. Because I think the health of the country has been impacted by the pandemic in non COVID ways. In terms of people putting off preventative care. So that’s a plus. Staffing is a huge factor right now. Burnout of staff as the pandemic continues, we can’t talk about it being over as we maybe wanted to, I [00:05:30] think, early in the summer.
[00:05:31] So staffing capacity, staffing burnout, being able to recruit new staff, all affects how much access there is to care. So what’s that balance between bringing people in for care when there’s a surge in the pandemic that we’re currently going through and you’ve got low staffing.
[00:05:54] So that’s what, that’s what organizations need to balance. You look at the bottom line, you look at your workforce, add [00:06:00] to that the and I know you don’t want to talk about vaccines, but add to that that hospitals are requiring more and more. And now with Biden’s ruling or executive order last week, it definitely will require hospitals requiring that need for their employees. So what does that mean in terms of even more staff churn, if you will, as people go through that process and potentially decide to leave the organization. So [00:06:30] a lot of factors that executives need to balance right now. And I would say in terms of the numbers, when I see the financial numbers at Boston Children’s where I’m still doing the interim CIO role.
[00:06:41] We’re slowly coming back. We use 19 as our benchmark in terms of where we want to get to, but we’re slowly coming back.
[00:06:47] Bill Russell: Right. One more thing I’ll throw in there too. I have some clients I’ve been talking to and people I’ve been interviewing and one of the things that’s happening is the metropolitan areas are [00:07:00] going outside.
[00:07:01] And some of the places that are experiencing a search are going outside for nurses and for clinical informatics staff and those kinds of things. And they’re throwing the .. the pay scale is out of whack. So they’re going to some of these rural areas, which are already pretty tight with nursing shortages and clinicians shortages.
[00:07:21] And those people are essentially walking away from their hospital jobs and they’re taking jobs for traveling nurse type [00:07:30] roles. And right now those roles are paying like four to five times what they would make normally as a nurse in those markets. And they’re just getting on a plane and following the money.
[00:07:40] And my guess is their thought process is this is what I’m going to do for the next year or two through the pandemic. Make three to four times my salary and then quite frankly, when, when the pandemic does wind down or come to an end I’ll just go back and get my nursing job.
[00:07:57] Sue Schade: Yeah, yeah. Or retire. In terms of nursing and [00:08:00] aging of the nursing workforce.
[00:08:01] Bill Russell: Yeah. The clinical informatics staff is really interesting too, because we have larger implementations, higher salary ranges going into mid tier, what I always call mid tier markets.
[00:08:13] Right. They’re not huge markets but you know Boise or I guess St. Louis is maybe a middle market those up, but they’re going into these markets where they have trained staff who understand clinical informatics and they’re offering LA New York, [00:08:30] Boston salaries to people who live where they live and that’s also throwing things out of whack too.
[00:08:36] So we, we have this rework of the labor pool that’s happening. I would assume that’s a very big conversation that’s happening at a lot of health systems. Like how just, how are we going to take care of our staff is probably first and foremost. Burnout. They’re just working like crazy. And that’s one of the things that struck me here.
[00:08:58] We’re going to expand the [00:09:00] clinic hours and we’re going to drive for higher productivity within our physician, seems to be at odds with, with, Hey, we’ve working these people like crazy over the last two years and we need to get our financials back. Therefore, we’re going to put the burden back on the on the physicians.
[00:09:20] This is where I come back to the health IT conversation because a lot of this will end up being things like, okay, how can we be more productive? What [00:09:30] tools can we bring to bear? How can we engage the patients that have delayed care? How can we get more efficient with our scheduling to make sure there aren’t open spots?
[00:09:41] And those kinds of all those things that some there are tools and there are things around that we could be implementing. So, I mean, how does health IT engage in those conversations, do you think?
[00:09:53] Sue Schade: Yeah, so I think there’s two threads here in terms of the the discussion and the need and where health [00:10:00] IT engages. One is for the clinicians. What can we do to make their lives easier to make their work more efficient in terms of the system that they have? That they’re using. And we all know that what do people say? No physician likes their EHR, with many complaints. And it’s a contributing factor to burn out.
[00:10:19] But you know what small things can we do to make it easier and more efficient for them. One of the things that Boston children’s hospital through the innovation group and John [00:10:30]Brownsteins leadership, he’s the Chief Innovation Officer. They do a twice a year. Call for pain points to employ. Where are the pain points in your work?
[00:10:41] And then that is summarized and worked in terms of what new things do we need to be able to do to provide to them and what things we need to be leaking. If you look at the Patient side patient engagement how can we make that journey easier for [00:11:00] them? And that’s a lot of leveraging your core vendors.
[00:11:06] It’s a lot of ad-ons where the gaps exist and really focus on that digital front door as we talk about and making it easier and more accessible to our patients. So those are two of the thread I think that IT team leaares and definitely get involved in those discussions.
[00:11:22] And the question about culture and burnout, I think is not just serving the organization, I’d say [00:11:30] also have staff, right? Right. No. Are my people at Boston Children’s burnt out? What do we need to do? Resume fatigue and the long days, and how do we address their, their issues as workers as well?
[00:11:43] Bill Russell: Yeah. So I’m probably going to go to the remote work story next, but as you were talking, I was thinking one of the things we did at St Joe’s back in the day was we used to mine the feedback. And so we were always looking at work, where are we getting feedback? Some is direct, some [00:12:00] is indirect.
[00:12:00] And one of the things we used to do is we used to mine the support desk tickets. And we had an analytics person, an analyst who essentially was going through that and they would provide us feedback as leadership. And they would say, look, there’s an awful lot of calls around this. There’s a lot awful lot of problems around this.
[00:12:19] And they would create these really cool visuals for us that we would say if we could solve that problem, we would really eliminate a significant burden for [00:12:30] this group. And some of it was just directly it related. We had too many session resets. And a session reset meant that a clinician was working. They were talking to a patient, they were actually doing something and something locked up and so we’d would look at that and say, all right, this seems to be a recurring problem, we have to do something on our Citrix platform and we reduce that number almost 80% and saw those tickets sorta go away.
[00:12:55] It’s that kind of stuff that you don’t think directly impacts clinician [00:13:00] but it does. When they’re in the room seeing somebody and something doesn’t work the way it should, that throws them out of their normal workflow, their normal rhythm and creates an angst, something they need to work around.
[00:13:12] So we, we would mine those tickets. That was one thing. We did a clinician survey. And we brought in a professional firm and we were again a $7 billion health system. So we brought in a professional firm to help us create a survey that we went out to all of our clinicians. We did that roughly every [00:13:30] three years.
[00:13:31] And that feedback was gold. In between those surveys, obviously, as the CIO, you’re, you’re rounding, you’re talking to people, you’re collecting information all the time, but those things are loaded with reducing the burden on staff, giving them time, back in their day, taking out the nuisance factor, improving the workflows, all that stuff I think is is so important at this point. And every little bit helps. I think.
[00:13:58] Sue Schade: It does. [00:14:00] It does. And if we can just springboard off that for a minute you’ve just given me an idea. We have not been, to my knowledge, mining that help desk service ticket data, and probably something that we should be doing, or I can talk to my CIO as I do the transition and recommend some things that she should take on. We do 2 other things, you mentioned the survey. Did Arch Collaborative exist as part of [00:14:30] KLAS when you were CIO?
[00:14:31] Bill Russell: It didn’t and it’s phenomenal.
[00:14:33] Sue Schade: It is phenomenal. And we we joined and participated this year and in the survey we did the survey over the summer. In fact, I think one of my calls today is to review the next round on the survey results and how we’re going to present that internally to our clinical leaders.
[00:14:49] So that’s critical. That’s directly clinician satisfaction, both physicians and nurses, and like the dice belt correct away though. That’s an important piece. One other piece that I [00:15:00] would just mention you talk about rounding. Rounding is harder in this period of time in terms of the pandemic.
[00:15:07] And we do at Boston Children’s something called Rounding to influence. And it is a twice a month, a very structured kind of rounding. I’m sure that lots of other kind of rounding that happens, but this is one where there are questions posed for leaders to take to their areas and have the discussion and solicit [00:15:30] feedback.
[00:15:30] And I encourage my CMIO and senior director, who’s responsible for clinical system to participate in some of the clinical unit rounding that’s happening. To hear feedback on those questions. And then I, along with my VP of IT operations host around influence session virtually or staff within IT. Getting that frontline feedback in all areas is absolutely critical.
[00:15:59] Bill Russell: Yeah [00:16:00] that’s fantastic. If people want more information on the Arch Collaborative, obviously you can go out to KLAS and get that information. We did a, an episode. So if you hit thisweek health.com and in the search, just put in arch collaborative.
[00:16:13] You’ll get to an episode that I did with Taylor Davis wwho’s the EVP of analysis and strategy for KLAS. And all we talked about is the Arch Collaborative for about 40 minutes. I love the sophistication of that is in its simplicity. They don’t ask, they don’t send out a [00:16:30] survey with 50 questions.
[00:16:31] It’s a very simple survey. And so I think because it’s, so it’s such a simple survey, it collects a lot it gets a lot more feedback than you would normally get from large surveys that you would generally see out there so
[00:16:44] Sue Schade: Just one more point on that. Just getting that data within your own organization from your clinicians is helpful, but then there’s the benchmarking aspect in terms of your peer groups.
[00:16:56] Bill Russell: Okay. All right. So let’s, let’s hit this Wall Street Journal article and [00:17:00]it is behind a paywall so I apologize to people for that. I subscribe to more things now than I ever did doing the Newsday story, but I subscribe to Modern Healthcare, subscribed to stat news, to a bunch of them just because they put out some good content.
[00:17:13] So a Wall Street Journal article is “Remote work may now last for two years, worrying some bosses. Many employees develop new routines during the pandemic. Swapping commuting for exercise or blocking hours for uninterrupted work.” These sound [00:17:30] like good things. Even staffers who once bristled at doing their job outside of an office have come to embrace the flexibility and productivity of at-home life.
[00:17:38] Over the past 18 months, many say surveys have shown enthusiasm for remote work and has only increased as the pandemic has stretched on. And they talk about return dates being postponed by many companies. It seems like mostly they’re talking large organizations here, but a lot of health systems would fall in that category.
[00:17:57] And then the last two things I’ve highlighted in this article [00:18:00] are some of the things that they know towards the end. Perceptions of a roadwork have shifted as the pandemic has gone on. It seems to be a recurring theme in this. And what many have concluded over time is that there companies can operate largely effectively while remote executives and workers while remote. So they’re saying, Hey, they can be effective operating remotely. Can healthcare operate well remotely is probably no cause there’s a lot of fiscal [00:18:30] touch points. Can health IT operate well remotely. What are your thoughts on that?
[00:18:40] Sue Schade: I don’t know that my thoughts have changed significantly in the last few months. I continue to be concerned about IT direct support and engagement with our clinical users. The value of our folks who support those symptoms having [00:19:00] close and in-person relationships, rounding, we were just talking about, I think is critical and that is very difficult in the remote world. And I think that IT organizations need to find ways to accommodate that and structure it. And not assume that it can all be done remotely. That’s the biggest, most targeted I know that for all the infrastructure work we’re doing, we’re making it happen.
[00:19:27] If we’ve got to have people onsite and data [00:19:30] centers or they can handle it remotely, we’re just making that work fine. The other thing is the relationships overall and as I wind down. Boston children’s and our new CIO Heather Nelson coming from University of Chicago medicine starts the week of October 11th and I’ll do the turnover with her that week.
[00:19:52] I connect with people that I’ve not worked with remotely primarily over the last six months, it’s like, I’ve told [00:20:00] some of the leader at the hospital on our Zoom calls. I just wish it were different. I wish that I could have been more in person and able to build those relationships that are so critical. You do what you can in this Zoom world.
[00:20:11] Bill Russell: There’s a handful of things I always say to people. One is you can’t replace face to face. there’s. There’s something about being able to read the person be able to sit across the table from them sitting in a restaurant.
[00:20:22] These are, I’m talking about these things like the good old days, but you know, sitting in a restaurant across from a colleague, having a conversation, another [00:20:30] colleague walking by and having a short conversation. There’s just, there’s a lot of things that happen that are good in that, that I think we missed out on. I worry about the next generation.
[00:20:40] I get emails every now and then on this, I know it’s effective. I know you can be effective at home. I know that you can do your job at home. All those things are true. But I worry about the next generation missing out on the relational aspects of working with colleagues. And I worry about them missing out on promotions that are going [00:21:00] to go to people that have relationships. I know that we’re supposed to be robots now and, related to that all promotions and whatever are done based on some objective criteria, but the reality is you like hiring Heather as the new CIO. You’re comfortable with Heather. You’ve interacted with Heather.
[00:21:21] Those things happen and I’m worried about the next generation thinking, well, how did I get passed over for that? Well, you’re working out of your house. People don’t really know you and you’re like, well I [00:21:30] interviewed just like they did over that three week, four week period.
[00:21:33] But in reality, the person who’s on really developed a relationship over a two year period. So when it comes time to make that decision of should we give the promotion to this person who has been in their home and we just interviewed them. I like them. They’re smart, they’re talented, but this other person is smart and talented and I have a relationship with them. I just feel more comfortable with this person. I’m, I’m afraid we’re going to overlook that group. And maybe I said too much in that [00:22:00] explanation, but I think there is something to people getting overlooked for promotions and those kinds of things who aren’t in the office.
[00:22:09] Sue Schade: Yeah, I think I think it’s a valid concern. But if your whole team like take IT as primarily remote or some hybrid then everybody may be in the same boat, right. It’s probably not a good example to use Heather and a CIO level where we did have the finalists come in in person and, and meet right.[00:22:30]
[00:22:30] But if we go from internal promotions in the market overall, and people moving around, there’s a tremendous amount of people changing jobs. Leaving where they are and taking other positions. And there’s that huge increase in if it’s virtual, I can work live and work anywhere right.
[00:22:50] You just kind of wonder how, I mean, I think this story is yet to be told. If you’re changing jobs and you’re virtual and you never [00:23:00] meet your boss, you never in-person, you never meet people you’re going to work with two years from now. How does that play out? Where do you fit in that organization?
[00:23:11] Bill Russell: It would stand a reason that turnover rates are going to go up in a remote working environment. Don’t you think?
[00:23:17] Sue Schade: Yes. Yes, because you have more options. If you’re working virtually for a company in your town and you’re not commuting anymore. Why can’t you work virtually for company across the country? [00:23:30]
[00:23:30] Bill Russell: Right. Well, I mean there’s the options. I dunno it’s like, you’re not going to really miss people. I mean, if you started, let’s assume you started in March of last year, working where you’re working and you are now a year and a half into your time there. And somebody comes and offers you $3 an hour more, and you’re not thinking, oh, I’m really gonna miss these people. And I really developed relationships and those kinds of things. You’re just doing work. And $3 an hour is $3 an hour.
[00:23:58] Sue Schade: There’s [00:24:00] still relationships. There are still relationships, even in this virtual world. You’re not just a cog now on some giant wheel. But it is different. It’s not the same. It is not the same kind of relationships I’ll give you that.
[00:24:15] Bill Russell: Well, so talk to me about managers and what do you say to managers? So clearly you don’t have a one-on-one relationship as the interim CIO. A one-on-one relationship with everybody in health IT and so it [00:24:30] it’s always, actually, even when were on site, it’s always been the case that people will leave a company more based on who their direct manager is than who their leadership of the entire organization is and those kinds of things.
[00:24:41] So how are you working with your managers to ensure that they are they’re connected, they’re listening. They’re responsive to the remote worker.
[00:24:52] Sue Schade: Great question. And to, to your leave and join comment. I think what I’ve heard in the past is people join an organization [00:25:00] and they leave because of the manager. Right. You’ve heard that.
[00:25:04] Bill Russell: Yeah, absolutely.
[00:25:07] Sue Schade: So I mean, Honestly, I’m not working directly with our managers. We have a manager meeting once a month that I participate in all virtual. It is hard when you have that many people on a Zoom to make those connections. I’m counting on the directors to be working closely with their managers and have those relationships and helping them.[00:25:30]
[00:25:30] We have an upcoming managers meeting that we’re going to do breakout rooms to discuss certain topics, which I think will be important for just more connection, more thinking something through. I don’t know that we’ve done the Zoom breakout room that much, but that’s a helpful tool in this virtual world. I would say I have a pretty good, at six months one-on-one relationship with each of my direct reports in terms of knowing them, knowing what makes them tick. Helping them, supporting them. [00:26:00] I’m not speaking exclusively about that group, but a couple people have already said, would you be willing to stay connected and be a mentor when you’re gone?
[00:26:09] So you, you do even in virtual world, form some of those connections that when you leave them are going to carry on a different forms. But it’s, it’s a complicated thing. If I can make one plug and I’d love you to add it to your show notes and I’ll send you the link. One of my colleagues at Starbridge Advisors, Russ [00:26:30] Rudish, wrote a blog on remote work called Now what? Working in a post COVID world. And he’s got kind of a lifted advice and considerations for both employers and employees that I think is a pretty good synopsis. I’ll send you the link. You can add that to your show notes. Okay. I know everybody’s got an opinion and writing about this topic and there’s still chapters to write.
[00:26:57] Bill Russell: All right. So 10 minute warning [00:27:00] here, cause I know you have a hard stop. Lets do is healthcare too hard for big tech? Okay. So a couple things happened. One, David Feinberg left Google health. They did a reorg and moved all the parts of the healthcare organization out into the various business units. Apple moved back from a thing they called health habit. An app called health habit, which was supporting their internal employees. Through a partnership with AC Wellness. I didn’t read too [00:27:30] much into that because that was like just in their campus in Cupertino. And it just never seemed like they were going to scale that.
[00:27:40] And then some some healthcare dignitaries weighed in on this, a couple of former guests of the show. Sherrie Duval. She had a post on LinkedIn that went viral. If companies misunderstand evidence-based medicine, they have no business bringing technology into medicine at all.
[00:27:58] I commented on that and we could talk about [00:28:00] that. Glen Tullman who is a previous guest on the show as well. Livongo now with Transcarent had this to say, big tech was struggling in healthcare because patient’s problems are more about the overall experience than technology per se.
[00:28:16] And then Dr. Nick Patel, Chief Digital Officer at Prisma health had this to say about apple scaling back the multi. Trillion dollar health care industry is a hard nut to crack. There are too many complex variables to [00:28:30] solve and healthcare tech space is already too crowded. Which is trying to solve for a tiny part of the overall tangled mess.
[00:28:39] So that’s, that’s what some people are starting to weigh in here. There’s more to the article. I might hit some of it a little later, but I’m curious as you hear those comments and in this whole thing, what’s your initial reaction to is healthcare too hard for big tech?
[00:28:54] Sue Schade: Should I, should I start with who knew healthcare was so complex quote.
[00:28:58] Bill Russell: Okay.[00:29:00]
[00:29:00] Sue Schade: Right. We’re there?
[00:29:01] Bill Russell: Clearly, I mean, we had a lot of things that the previous president said that were pretty silly. That has to rank up there in the top. Who knew healthcare was this hard? I mean, my mom knew healthcare was this hard. Right. Everybody knows healthcare is hard.
[00:29:18] Sue Schade: I’ll give you that. So I thought this was a really interesting article. I’m glad you mentioned what Tulman said about a patient’s problems. Healthcare is more about patient’s problems than the experience with [00:29:30] technology. I think that’s an important point.
[00:29:32] I want to flag a few other ones here, if I may. There’s also something in the article about viewing it as a part-time job and the fact that it’s just one component for these big tech companies versus the full focus as a factor. There’s also something here about big tech firms willing to solve the healthcare problems by themselves and you already quoted Nick Patel. He offers another suggestion. If major technology [00:30:00] companies came to the table together at the national level to solve this problem, instead of trying to get a piece of the trillion dollar pie, then maybe we will have a shot at fundamentally. We do think cost and improving outcomes.
[00:30:11] I think that’s an important point too. It’s like it takes a village it’s complex and it takes a village to solve. So I’m not sure the question you first posed to me but interesting article in terms of what’s happening with big tech and why they’re succeeding or not succeeding. And [00:30:30] yeah, I’m gonna throw it back to you.
[00:30:34] Bill Russell: Yeah. So I’m going to stir the pot a little bit here. I agree. So the healthcare sector gets only part-time of the CEOs tension at these big tech firms. That is absolutely true. We’re hearing that the health initiatives are scattered across the organization so they lack focus. They lack a cohesive enterprise strategy around healthcare. That is true as well. When I read Nick Patel’s thing, I sorta, I [00:31:00] struggled with it. If major technology companies came to the table together at the national level to solve a problem, instead of trying to get a piece of the trillion dollar pie, then maybe we will have a shot at fundamentally reducing costs and improving outcomes.
[00:31:14] That’s not their job. These are publicly traded companies, their job isn’t to reduce costs or improve outcomes of healthcare. I mean, their job is to grow revenue and that’s what each one of them is trying to do. They’re trying to take a piece of the trillion dollar pie and do that now in the process.
[00:31:29] [00:31:30] What they’re saying is healthcare, the experience for healthcare is fundamentally broken and consumers want something different. They’re not wrong in doing that. Amazon has carved out. Pretty interesting PBM type play. They’re going to do pretty well with prescription drugs and the delivery of prescription drugs, probably as effective, if not more effective than many of the big players that are out there today, Google has carved out a fairly significant [00:32:00] data business. They have a ten-year deal with Mayo. They have a long-term deal with Ascension. They just did a long-term deal with Tom and spirit. So they’re carving off a piece and that’s, that’s what they do. They’re carving off a piece. They’re not really after, Hey, let’s reduce costs and improve outcomes.
[00:32:17] That’s the job of healthcare. And my thing back to Nick would be if you say, Hey, Tech companies should all get in a room and figure this out. Why doesn’t healthcare [00:32:30] get in a room and figure this out.
[00:32:32] Sue Schade: Fair enough. Fair enough. I would go back to are there problems that big tech companies can solve at scale? And if you remember back early days of the vaccine, we talked about Amazon’s got this huge distribution network, how can they help with the vaccine distribution. They can do stuff at scale. So are there particular problems within the healthcare eco system that [00:33:00]make more sense for the big tech firms to be tackling?
[00:33:03] Bill Russell: I’ll tell you here’s here’s one of the more interesting things somebody asked me last night what’s the COVID-19 rate in Florida and I thought, oh, I haven’t been following the numbers as closely lately. So I thought, oh, I’m just gonna put a Google search in here. I’ll tell you what Google can do really well. They have all the stats. Okay. I mean, you just put a simple search in there. You can get hospitalizations, you can get positivity rate. You can get seven day averages. [00:33:30] You can get cases, death count. All that information, I mean, when we went back early on, we all went to the Johns Hopkins.
[00:33:36] That was the only place really to go. And then they started sprouting up. Google now has a pretty good handle on this stuff. And that data is available to anyone who can, can put a search in. So there, there are there’s any number of ways that I think big tech is going to participate in healthcare. I love by the way, one of my favorite episodes this [00:34:00] year was with Glen Tulman cause I’d love a lot of the things he said, and it was along the lines of what he said here, which is it’s really about the experience. And so he has tech as a part of his solution at Transcarent but he also has this concept of everybody wants to talk to a person, so we no longer do phone trees and everyone who is a Transcarent client will talk to a person within 60 seconds.
[00:34:24] He’s like marrying the two and saying, what are people really after and they’re after a better experience all around. And [00:34:30] so he’s he is working with providers to address one of their biggest challenges. And he’s essentially paying for surgeries up front, which is which is a pretty interesting place. And then on the consumer side, there’s just a whole host of things he’s doing. Giving people a, they do have a good, pretty good front end, but they also have the phone conversations and then they offer that direction of where can they go? How can they connect with the [00:35:00] right provider at the right time?
[00:35:01] So it’s, I think it is too complex for big tech from that perspective. And I also think our expectations of big tech. And he closes this article and I love Paddy. Paddy has been on the show as well. I think he’s he’s a great thought leader in the digital space. But he closes this with saying and why doesn’t Amazon, Apple and Google come in and buy one, one of the big healthcare providers like Amazon did with buying Wholefoods to get into the grocery business.[00:35:30]
[00:35:30] And the answer is they don’t want to be in the healthcare business. They don’t want that level of regulatory oversight, which is why Google and Microsoft both dropped out of the patient health record aspect because both of them, by doing that, we’re opening themselves up to all sorts of government oversight and scrutiny that they just said not worth it.
[00:35:50] And so I don’t anticipate Google, Apple, or any of those coming in and buying, I don’t know, Providence or, or [00:36:00] CommonSpirit. I don’t even think that’s on their radar.
[00:36:05] So not to be critical. I love Paddy. Oh my gosh. We spent 10 minutes on that story. I will touch on this. Digital health is a cultural transformation. This is from the medical futurist. It’s an article worth looking at. The future of healthcare. He has an infographic in the middle of traditional medicine versus modern medicine. And point of care he has hospitals and clinics and labs, traditional and modern medicine has patients. [00:36:30] Traditional population, modern medicine is going to be around the individual. Getting to that end of one. The organizing principle of traditional is hierarchy and partnership is going to be modern medicine. Institutions is data ownership. Patient ownership is patient ownership of their own data is the future. Physicians roles as authority is traditional in the future. He has guide. And then he has [00:37:00] ivory tower of knowledge. And then he has healthcare really figuring out how to participate in this ecosystem of social media, crowdsourcing to get our knowledge base out into the the the public square where people are talking about healthcare. I guess I, I thought that was an interesting graphic. What are your thoughts on that graphic?
[00:37:20] Sue Schade: Love this article, love the graphic. Absolutely. So it’ll be in the show notes and I would encourage people to look at this infographic. The very first [00:37:30] one point of care is something I have a real-world experience with very recently and covered in my most recent blog. You can put a link to that too. I had a bone density test portable in my home. They’ve done a phone call from the insurance company after my fall saying claims information shows you [00:38:00] had a fall and that you need to get a bone density test, and we’re going to be in your area on September 15. Can we schedule that? And I’m like a portable? So read my blog. I mean, I was like, okay. And we did it. And it’s like, oh, so yeah, that’s shifting in terms of where certain care options that are available.
[00:38:21] Bill Russell: That’s fascinating. Well, Sue it’s great to talk to you. Congratulations on the Boston’s Children’s, you’re winding that down in October, Heather Nelson taking [00:38:30] over. That’s fantastic. And so I imagine that means there’s going to be an opening in Chicago for a CIO role.
[00:38:40] Sue Schade: It’s it’s. It’s all good. They’re fortunate to have Heather and I look forward to doing the handoff. It’s been a good experience. I always enjoy talking with you Bill and I always learn something new and get them new ideas percolating here. So thank you.
[00:38:54] Bill Russell: Thanks. Always great to catch up.
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