Newsday – Vaccine Distribution, Telehealth vs Real Estate and the Future of Healthcare Conferences
January 18, 2021

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January 18, 2021: Anne Weiler, health tech entrepreneur and advisor to This Week in Health IT joins Bill. Together they hit vaccine distribution, telehealth vs real estate and the vaccine credential initiative. Is it easy to find out how to schedule a vaccine appointment? Do you know when you can schedule it? Are you clear on the efficacy of the vaccine? Do you know which one you’re going to get? Plus what did the JP Morgan conference conclude about 2020? What are they projecting for 2021? Are health systems ever going to return to what it was like pre-COVID? Or is that just a pipe dream? Have we now moved into a different model? What kinds of things can we do to get people back and volumes up? 

Key Points:

  • From March to the end of May 2020 you saw a big donut appear in everybody’s financials [00:03:30] 
  • One of the biggest themes for 2020 was diversification [00:03:55]
  • In March 2020 Boston Children’s Hospital saw a drastic change in asthma-related visits to the emergency room. They went down by 80%. [00:10:40] 
  • Telehealth is interesting because it comes down to incentives [00:12:50]
  • I really hope that healthcare systems aren’t making decisions for patient care based on real estate [00:15:05]
  • How are the mentally ill and the homeless going to get the vaccine? [00:21:51]
  • CVS, Walmart, Amazon and other disruptors are seeing huge opportunities in healthcare [00:29:20]

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Newsday – Vaccine Distribution, Telehealth vs Real Estate and the Future of Healthcare Conferences

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Newsday – Vaccine Distribution, Telehealth vs Real Estate and the Future of Healthcare Conferences

Episode 353: Transcript – January 18, 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. 

[00:00:18] Special thanks to Health Lyrics, who is our Newsday show sponsor, for investing in our mission to develop the next generation of health IT leaders. If you want to be a part of our mission and become a show sponsor, send an email to [00:00:30] [email protected] Quick note, we launched a new podcast Today in Health It. You can hit it at todayinhealthit.com. You can subscribe wherever you listen to podcasts. We do roughly a six to eight minute show. Every weekday morning we take a look at one news story and we break down for you from a health IT perspective, from a CIO perspective, and it’s great way to stay current. Great way for your staff to stay current. So recommended to  some friends as well. Check it out and subscribe wherever you listen to [00:01:00] podcasts.

[00:01:00] Today we are joined by Anne Weiler, who is a health tech entrepreneur, actually recovering health tech entrepreneur. I guess we’ll call you and advisor to This Week in Health IT. You have been for over a year, and I’m looking forward to this conversation. Good morning Anne. Welcome to the show. 

[00:01:16] Anne Weiler: [00:01:16] Hey Bill. Thanks for having me. 

[00:01:17] Bill Russell: [00:01:17] So one of the rotating cohosts of the news day show. And the thing I’m looking forward to, with you is I talked to a lot of people who are inside of the provider space and you [00:01:30] are technically outside of the proprietor space.

[00:01:32] So we’re going to talk a lot about different things that are going on on the periphery things that are going on in the in the tech community and those things. But we’re also going to touch on. The you know, we have to talk about vaccine distribution. It’s top of mind for everybody.

[00:01:49] We’re going to talk about the vaccine credential initiative a little bit. And I think where we’re going to start though,  we’ll start  with JP Morgan. You did not get to attend, but I did [00:02:00] attend, so we’ll do this as the I’m telling you what went on and thenyou can comment on it.

[00:02:07] Now the JP Morgan conference for me is a chance to really sit in on some board discussions, right? So you get a chance for me, I sit through the nonprofit track and this year it was Advocate Aurora Prisma Health, Mass General, Brigham Intermountain, SSM, Baylor Scott and White, Northwell, Common Spirit, Ohio Health,Blue [00:02:30] Shield of California, Spectrum Health.

[00:02:33] That was day one. Admin Health, Ascension, Jefferson Health Providence, Henry Ford and ProMedica was the second day. The thing, the reason I sit through this is, it’s a CEO, CFO presenting to institutional investors, bond holders, and the like, and they they sort of talk about what happened last year.

[00:02:54] They talked about what’s what they’re projecting to happen this year. And there was a lot to [00:03:00] talk about. And then they also give you a snapshot into the financials. Now, some were more let’s just say, open with their financials than others. Some you got a full picture of their balance sheet and their operating margins.

[00:03:15] Others were a little coy with how they presented it. But that’s their prerogative and whatnot. But for me, it’s a chance to say, all right,  what happened this year? And as we looked at it what happened to shares exactly what we [00:03:30] thought. From March to March, April, May, roughly the end of May, you saw this big donut appear in everybody’s financials.

[00:03:41] And it was a, it was as obvious as you can be, you didn’t need an MBA to figure this out and just looked at the financials and you’re like, okay, this was the curve ball. Everyone had to deal with it. And we got to see how they’ve dealt with it. Now I thought one of the, one of the bigger themes from this year was again, [00:04:00] just diversification. If a health system was diversified going into COVID they weathered the storm pretty well. Now most of them weather the storm pretty well. I mean, you’re talking about some established health systems here. They, if they if they weren’t diversified, they recognized that early on. And they went out and they shored up their balance sheet. They went out and they borrowed money. They made sure they had access to capital throughout COVID and almost everybody actually everybody who’s on this list received cares vac [00:04:30] money.

[00:04:31] And that filled let’s just say about three quarters of the whole, maybe, maybe, two thirds of the hole that was created during that time. But the challenge was that was the, that was the gaping hole, but then the health systems had to figure out a way to get people back. And while it, popped back pretty quickly. it’s still not back to a hundred percent for most of these health systems, I guess, bringing you into this conversation, what do [00:05:00] they need to do?

[00:05:01] Are we going to return to what it was like before? What kinds of things are people going to do to get people back and get those volumes up? And is that just a pipe dream? Have we now moved into a different model? 

[00:05:13] Anne Weiler: [00:05:13] I hope we’ve moved in into a different model. You know, I’d be interested to know whether you saw telemedicine heading, like were their actual revenues there because in the beginning it was being reimbursed at the same rate as in-person.

[00:05:27] And so and [00:05:30] you know, this is obviously, I’m both a person and a pundant now. Thank you for bringing me a funder. but you know, I remember trying to do an online visit, with U Dub, University of Washington medical center here in Seattle when, when we, when COVID started. And I think I was like 12 hours on a waiting, like all day long, refreshing you’re waiting, you’re waiting.

[00:06:00] [00:05:59] You’re bumped down. You’re up, you’re down. So like the volumes of Thomas in the beginning, We’re we’re quite high. Now there’s this question of, is the reimbursement going to stay at the same level? So how much was that coming into it? But when we think about like the levels, they, there was this obviously elective surgery is the, the revenue driver and so many elective service surgeries were canceled or postponed. I don’t know that they’re quite back yet, and those elective [00:06:30] surgeries are not, this is not cosmetic surgery. This is knee replacements, but also follow up from cancer surgeries, like again, anecdotal, but a friend of mine, had survived colon cancer this year. And the removal of what can I say, colonoscopal bag was considered elective surgery. And that got postponed as with another wave. So it does, like, I [00:07:00] think there’s going to be a ton of pent up demand because those are the, those are the things there’s a whole bunch of like, brain surgery.  If it’s benign, that’s also elective, believe it or not.

[00:07:12] So, if you stack rank these like things that are urgent, all of those things, surgeries need to happen. And then we’re going to have this huge backlog of the knee and hip where, you know, you you’re in pain, but it’s not life-threatening. so I think there’s, there’s definitely I [00:07:30] think two things.

[00:07:30] One, I think we saw it at the beginning. one of the things with telemedicine has been the physicians, like, again, Twitter is such a great source of information. I remember the beginning of the pandemic number of physicians that I follow are actually tweeting like, Oh, you can do. A visit without putting your hands on the patient and, and, as much as no I’m serious, like as much as that this is true, a lot of them had to [00:08:00] experience it. 

[00:08:02] Yeah. So I think, and then there becomes this question of the licensure thing is that if those, restrictions, are lifted or make it easier to do cross state telemedicine. Then what happens is now every health system in competition with each other, if you can get a patient from a different state.

[00:08:25] Bill Russell: [00:08:25] So yeah, so you brought up a lot of stuff. So [00:08:30] first of all, the. We, we need to do an education process on what elective surgeries means to the general public. When they first heard that they were like, yeah, that makes perfect sense. Now, anyone who was in healthcare was like, Oh my gosh, do you realize what you just did? And actually I think there’s an awful lot of hesitancy to do it again, that they have set triggers. In certain States they’ve set triggers. And if positivity rates or [00:09:00] a number of ICU beds or certain things, small blew a blow, a certain threshold, they are, they will Institute moving the elective surgeries out.

[00:09:13] Or the non-essential surgeries or whatever terminology you want to call it. But health systems are doing everything they can to make sure that that does not happen again. And so that, that was a huge thing, but the even more concerned. So, [00:09:30] surgeries drive imaging, they drive labs, they drive, they drive an awful lot of things that drive the revenue in a health system.

[00:09:37] The second thing that drives their pipeline is ED visits. and the emergency rooms are still down close to 14, 15, 20% in some cases. And, if that’s your theater, you’ve got to, you’ve got to find another theater. So that was one of the things that really came through is, they have knocked them up with [00:10:00] good strategies to get people back in the ed.

[00:10:02] There is still a fee for service world. And the reason I thought one of the themes was diversification is almost everybody’s talking. We’ve been talking about it for the better part of a decade, if not two, in terms of moving from fee for service to, more of a at risk for health. But nothing like an emergency like this to really drive home the point that, if you’re relying this much on fee for service and [00:10:30] you’re, you have you’re you’re at risk, essentially.

[00:10:34] Anne Weiler: [00:10:34] But that reminded me, when you talked about the ED, did you see the article, the study from Boston Children’s about asthma?

[00:10:44] Bill Russell: [00:10:44] I did not. 

[00:10:45] Anne Weiler: [00:10:45] It’s gone down significantly and no, impact, like not, no greater number of children being admitted with severe [00:11:00] complications, which kind of makes you wonder about, when you think about the over, I’m going to say overtreatment, and obviously any parent whose child can’t breathe it’s a very scary situation, but they basically saw significant decrease in these ED visits without any, as far as they can tell any impact on the actual health.

[00:11:24] Bill Russell: [00:11:24] John Brownstein’s gonna come on the show. I’m scheduled to talk to him in a couple of weeks [00:11:30] and I’m looking forward to it. So he’s there he’s like their data guru slash-

[00:11:38] Anne Weiler: [00:11:38] Yeah, he’s their chief innovation officer and an epidemiologist. 

[00:11:42] Bill Russell: [00:11:42] Yeah. And he’s, he’s on the news all the time now in their market and talking about this. So it will be that’ll that’ll give me another question to ask him.

[00:11:52] The the other thing you talked about elective surgeries and, and let’s just call it postponed [00:12:00] procedures and that kind of stuff. I, I think was Mark Arison. I think it was Mark Harrison, CEO of Intermountain was the only one I heard give a number. And I think he said they attributed close to a hundred thousand deaths this year from people not getting treatment at the right time.

[00:12:17] Or, or why we’re not coming into the ed or those kinds of things. I’d be curious to see where he got his number, but that, that wouldn’t shock me if you’re talking about the entire United States [00:12:30] close to a hundred thousand deaths due to it. 

[00:12:31] Anne Weiler: [00:12:31] No, no, the United, okay. I thought he was talking about like inner mountain.

[00:12:35] Bill Russell: [00:12:35] No, he was, he was talking about, he was talking- and I’ll have to go back and look at the transcript and see see what his source is. But I mean, that number would, would not surprise me. Really it also telehealth. So telehealth is interesting because it comes down to incentives again. Right? So one of the things, one of the things we’re seeing is that these fee for service arms are [00:13:00] essentially saying, Hey, that was a really fun experiment.

[00:13:02] I did like telehealth boy, that was fun. But you know what? I’m bringing people back in to see them in the office. I have a mechanism for doing this. I have I have real estate I need to pay for, I have. Staff I need to pay for. And so the incentives aren’t aligned, so it’s bringing people in and that’s one thing that’s going on.

[00:13:20] The other thing that’s going on is you’re seeing States, cause we haven’t seen it at the federal level to say CMS to say, Hey, we’re going to continue to fund this mostly because they don’t have the money to [00:13:30] do it. And we’re seeing States start to step up. So you’re seeing Massachusetts and I think New York, I haven’t seen another yet, but those two. Massachusetts being the most bold essentially is kind of backstop all the tele-health and say, at least tele-health for for behavioral health.

[00:13:53] And they’re, they’re going to backstop all of those visits and keep those funded at the at the [00:14:00] COVID rates. And I think there’s, don’t you think there’s going to be a big push on this to make sure this stays funded? 

[00:14:07] Anne Weiler: [00:14:07] I hope so, but you know, and you talk about the all these perverse incentives and we’ve never talked about this, but I used to, well, I am Canadian and I used to live in British Columbia.

[00:14:20] And while I was there most recently, which would have been like 2011 timeframe. The government was funding [00:14:30] tele-health visits higher than in person to try and drive the behavior towards telehealth. And the minute they stopped doing that, everybody dropped tele-health visits. So there’s like so many things going on here.

[00:14:45] It’s not just funding. It’s I think preference. And going back to your point about real estate, this, but possibly what might change this time is that everybody’s reevaluating the real estate, right? Not just healthcare, [00:15:00] like look at all the office buildings that are empty. Everyone is saying, do you know, how should we be thinking about this?

[00:15:05] So I really hope that that healthcare isn’t making a decision for patient care based on real estate. And that they are actually thinking about- like you think about it, like we’re in a pandemic, right. If I had the flu, you don’t want me going to a doctor’s office. Like that is a perfect tele-health visit.

[00:15:28] So I’m not going in there and [00:15:30] infecting everybody else. So there’s some really, really good cases and, and that’ll free up the in-person for the things that really need to be in person. Yeah. So I don’t know. I hope so. I’m hopeful, but I’ve seen, like, I’ve seen things that. You would have really hope. They, it wasn’t just money based. 

[00:15:49] Bill Russell: [00:15:49] Yep. Well, if, if listeners want a full breakdown on the JPM conference, I did a do an episode this Friday with [00:16:00] Rob D Michiei, former CFO for UPFC and he goes through the finance, nobody better to go through the financials and what it means and diversification and all those things.

[00:16:11] So if you want a really detailed breakdown, but you can go over there. I’m also doing a bunch of shows on today in health. It so you can go over to today in health I t.com and listen to some of those. Where I  broke down some of the themes and whatnot, and there’s going to be more of those this week that I’m still rolling out. I do want to get [00:16:30] to some, some other-

[00:16:32] Anne Weiler: [00:16:32] Before we go off JP Morgan, most important question was, did you have to pay for a Zoom call the way you had to pay for a table to sit in the lobby of a hotel? How did that work? 

[00:16:44] Bill Russell: [00:16:44] My wife charged me $800 a night during the JP Morgan conference now. I felt really at home and it just, it felt right.

[00:16:53] Yeah, I don’t think people can really appreciate how expensive that [00:17:00] conference is to attend. It’s nuts. But everybody’s there and some of those people that the only time I’m going to see them this year will be at that conference. So you know, so if they do it again in person next year, I will be there.

[00:17:18] In the in the hotel, on that floor, watching all those CEOs go up to the, go up to the podium. And it’ll be interesting to see if we’re at that point in January of [00:17:30] 2022. 

[00:17:32] Anne Weiler: [00:17:32] I’m hoping that conferences ended up being a bit more hybrid that you can participate without like there’s huge benefits to being in person, but you can’t always travel.

[00:17:44] I know that I think that health, the HLT DH conference, right. It seems I didn’t attend this year, but it does seem like they did a good job of going hybrid or sorry, going online. And I can imagine them doing more hybrid in the future. Cause they’re a little bit they’re a newer [00:18:00] conference. Let’s say that.

[00:18:01]Bill Russell: [00:18:01] Yeah. Yeah. They’re, they’re more tech savvy, but I’ll be honest with you. The, the benefit this year- because you’re, you’re the JP Morgan conference pulls you in so many different directions. There’s there’s individuals, you want to sit down and have a conversation with. There’s, you get invited to events that are right in the middle of some things that you want to watch and whatnot. So for me, I’m always pulled in a lot of directions and the nice thing about this was, I [00:18:30] missed, and I have a list of ones that I’m, I’m still listening to a bunch of, a bunch of the presentations and I went back and listened to them later.

[00:18:38] Which  is great. So I if I sit through the I sit through the, the nonprofit track, I missed the CVS presentation. I missed the Walgreens. Novidium presented. Teladoc, nuance. I mean, those are all things I want to attend, but you can’t be in two places. So let’s [00:19:00] talk, a little bit of vaccine distribution.

[00:19:03] And it’s interesting. I did a post. You’ll love this post and actually I’m going to hit, I’ll hit the post because I want to share some of the things that that, that people are talking about with regards to this, I said try this. Hit your state’s website and trying to get an information on the vaccine distribution.

[00:19:23] Now go to the County website. Now go to your health system website. Push your results below. How did it go? Was it easy to [00:19:30] find do how to schedule an appointment? Do you know when you can schedule the appointment? Are you clear on the efficacy of the vaccine? Do you know which vaccine you’re going to get? Doesn’t matter to you? 

[00:19:42] And I posted some things here that people are saying, and one of them is we spent $10 billion to develop vaccines and why we are not spending money to introduce the public to the vaccine. A physician in Charleston-based Medical [00:20:00] University of South Carolina told Bloomberg and I said, we can do this better.

[00:20:04] Well, this, this is probably the post for me this week that got the most action and people did it. They went out. So somebody from the state of California said, Hey, that information is almost impossible to find, but I know exactly how many deaths there are in the United States. So they’re, they want you to know how many deaths there are, but they’re not really helping you out on that.

[00:20:23] Sue shade went out. She’s one of the rotating guests. She went out after the show and said my state [00:20:30] Rhode Island still is only showing high level timeline for phase one groups. Nice visual showing phase one. So that’s a plus I asked a virtual chat about over 65, most recent CDC guidelines and it got a non-helpful answer.

[00:20:45] My health system website is not showing any information. We had somebody from Texas say they scheduled and got in and the information was readily available in my state of Florida, which I, I noted. [00:21:00] I can go to the County website, actually hit a schedule button and schedule the vaccine.

[00:21:06] Now it’s interesting. It’s not until I get in there that it says, you know what’s your age? Oh, you’re not, you’re not eligible yet. So that tells people I’m not over the age of 65, but in Florida we’re actually giving it. We’re actually to the next level, we’re giving it to-, we did the long-term care facilities and nursing homes, and now we’re starting to do people over the age of [00:21:30] 65 are starting to get lined up  for the vaccine as well.

[00:21:34] Catherine Sullivan, who is always giving me trouble, but I love the trouble. She gives me cause she always is talking about the people that we forget about, or the people that are not connected. And she’s, she’s talks about the mentally ill and she’s really trying to get me heat on this.

[00:21:51] She’s like this doesn’t take into account the mentally ill and the homeless and how are they going to get to it? And I was like, okay. Catherine, that’s a great [00:22:00] question. What do you recommend? She says we have to figure out a way to go to them and she’s, she’s not wrong. That’s true. I don’t know who’s doing that. I don’t know if that’s a public health effort or if it’s a hospital effort. 

[00:22:11] Anne Weiler: [00:22:11] I actually don’t know who’s doing this in it, but in my local park, there’s now a COVID test site, like just in the park. So that might be a way to do it. Yeah, I was reminded of, I don’t know if you said that there was an article in the New York times yesterday.

[00:22:27] And it was talking about [00:22:30] the trials of getting signed up and it says I’ll quote, quote this, because I think it’s very, quite relevant to IT. Buggy websites, multiple sign-up systems that act in parallel but do not link together, and a lack of outreach are causing exasperation and exhaustion among older new Yorkers and others trying to set up vaccination appointments.

[00:22:49] So we’ve got the typical health system. Or healthcare systems not talking to each other. And then we’ve got, an [00:23:00] we’re trying, who we’re trying to get to, or are the people who might be actually hardest to get to do. And it reminded me a little bit of a startup I’ve been advising called can-do tech.

[00:23:11] That is tech support for seniors. And they’ve actually started helping seniors sign up for their COVID vaccines. So like it’s one thing to put something out there. The other is like, is it actually usable? And as we know, usability is not always the highest order of things in healthcare. 

[00:23:28] And I don’t know, did anybody think [00:23:30] through this? Like, could you actually sign up as you were saying? 

[00:23:34] Bill Russell: [00:23:34] Yeah. And what’s interesting, somebody, one of the articles talked about. The the federal government didn’t set anything up. They pushed it down to the States and the States were sent scrambling. And I, and I said, you know what, that’s how I want it to be.

[00:23:49] I don’t want the federal government to come out with a program. My gosh, we we’d be talking about are you in line for the vaccine in like June of this year, by pushing it by pushing it all the way down to the [00:24:00] state. And one of the things I like is that a lot of the States really, they went to the health systems and said, look what’s your mechanism for reaching people and what they realize- I think what they realized is the health systems mechanism for reaching people is their portals and their portal signup is still the best are about 50% of their patients. That’s not of the community, that’s 50% of their patients. And so that’s their outreach mechanism. And so they stepped back and said, okay, well, that’s not going to be [00:24:30] enough.

[00:24:30] What’s. What, what are we going to do next? And then they, they put, they still engaged in local health systems. And then they stepped back and said, all right, what are we gonna do at the County level? And this is why I like what Florida in Florida took a lot of heat. They had lines and some other stuff which always happens at the beginning of something like this.

[00:24:47] But. It’s a common scheduling system and they’re using event bright. So they took key for using event bright, but you know what we have, we’ve all used event. Bright it’s really well thought out user experience. It’s really easy. You can provide them [00:25:00] additional information. So that’s what they’re doing at the, at that, at that site.

[00:25:03] I, I’m not trying to score political points in any direction here. I’m just saying I live in Florida, I’m watching this sort of play out. My neighbors did call me and say, Hey, how do I get the vaccine? And and it turns out the, the nursing homes and long-term clinics was the best orchestrated distribution, even in the state of Florida.

[00:25:28] And what they ended up doing was [00:25:30] getting, because there. They’re like 86 years old or something like that. They ended up getting the vaccine, not from the hospital, but at the local long-term care clinic, which, which they’re signed up to, to join him for long-term care in a, in a year or so. 

[00:25:47] Anne Weiler: [00:25:47] You asked me about like long-term impacts on telehealth.

[00:25:51] I’m wondering, will this have positive long-term impacts on public health. And [00:26:00] I was reminded of a comment that ED doctor Matt Kaiser here in Seattle said to me a while ago. But you know, we have, we’ve gotten to this point where we have. Often wildfires in the summer and really bad air quality.

[00:26:15] We have terrible air quality for the basically first two weeks of September this year. And what he said to me is he had no way of searching the EMR to find his patients that had asthma to [00:26:30] send them an email to say, do not exercise, do not go outside. And I’m just wondering, like, in trying to find these people who are qualifying for a COVID vaccine and doing this kind of search, will we get those kinds of capabilities?

[00:26:44] Like he wanted to proactively reach out to his patients and he couldn’t, because he couldn’t find them. So I’m, I’m hoping that this will, when you think of it, like, is this going to have long-term-

[00:26:53]Bill Russell: [00:26:53]  It absolutely. It will absolutely have long-term impact on public health. I mean, we’re already seeing, [00:27:00] just a bunch of conversations, start to kick in of what information do we need.

[00:27:05] And when the pandemic started, we still had the, the massive bureaucracy on top of this thing. And people were just saying, look, we’re in the middle of this thing. I don’t have time to collect nonsense information that you need for this and this. Why don’t you tell us exactly what you need, and that’s what we’re going to give you.

[00:27:24] And some people started working on what are the data fields that we actually need in, in [00:27:30] terms of the pandemic. And so I the same way I’m talking about that, there’s the same way I’m thinking about public health. I think people are going to step back and realize first of all, I think we’re going to define public health a little differently than we have before and the elements of things that we need in order to be effective and who are the players in public health. 

[00:27:54] And I’ll give you the, the one example, and this was a JP Morgan conference. This is a [00:28:00] combination of JP Morgan conference and vaccine distribution. CVS has done close to a million COVID vaccinations already, and they haven’t done them in their stores.

[00:28:14] They got the contract or whatever to do them in long-term care facilities because they were close enough. They had the the distribution mechanism and they had the healthcare system relationships. And so they, they [00:28:30] took their clinics. They went out to these long-term care facilities. They took the vaccine with them and they went to all these places.

[00:28:35] They did about a million and they said the next step for us is and, and to be honest with you, it’s probably much more effective than some of the things we’re trying to do today. And I think this is, these are the kinds of conversations we’ll have. So they’re going to go out. Yeah, or the next step is the federal government will essentially make them a distributor of the, of the vaccine and they’re just better [00:29:00] at reaching people, right? 

[00:29:01] CVS knows how to get a hold of me. The local health system doesn’t know how to get ahold of me. I haven’t been there. They don’t even know I exist in this market. Yeah. That’s yeah. And it’s not only that. This is, this is why we talk about new entrance and new entrance was a.

[00:29:18] Is always a topic at JPM. I mean, this is why the the, the CVS is the Walmarts, the Amazons and others, and, and, and the disruptors are seeing an [00:29:30] opportunity here. I mean, the landscape has changed so dramatically that there, there are opportunities to step in and say, look, you could try to build this whole network of things out, but if you want us to do- nobody does distribution bedroom, the name is not, nobody does.

[00:29:46] No, nobody’s in every market better than CVS and Walmart. And they’re they literally- health systems grew by acquisition, right? So they’re not necessarily all in the right places, but when they [00:30:00] put a Walmart in your local location, they do all sorts of research on, growth patterns in that community.

[00:30:06] I mean, they are in the right spot for, and they put in nice, big parking lots and all sorts of other stuff. And I have a feeling that public health partners will look a little different coming out of this. 

[00:30:19] Anne Weiler: [00:30:19] Who else is in the right spot is Starbucks like that. If the health systems wanted to get out in the community, they should have brought the Starbucks.

[00:30:32] [00:30:30] Bill Russell: [00:30:32] Seriously, they are everywhere. I mean, I guess, I guess the difference is that they would have to invest in the the infrastructure. 

[00:30:40] Anne Weiler: [00:30:40] I’m not saying Starbucks should do it. I’m just saying like, if you, if you want to be where the people are, that’s another indicator, like put your health clinic right beside Starbucks.

[00:30:49] Bill Russell: [00:30:49] Yeah. I mean, one of the first, 

[00:30:51] Anne Weiler: [00:30:51] there is one in Seattle. In, in the neighborhood where we used to have our Wellpepper office, the, there was a zoom care, right. [00:31:00] Beside a Starbucks. I don’t think that was a coincidence. 

[00:31:04] Bill Russell: [00:31:04] Yeah. Yeah. I don’t think that’s a coincidence either a vaccine. One of the things we talked about was the challenge of tracking the vaccine in the EHR and then getting that information out and whatnot.

[00:31:16] And one of the stories I wanted to hit on vaccine credential initiative was launched. And this is, yeah, this is pretty good. Interesting in that let’s see vaccine credential initiative. Let me find this one [00:31:30] participating organizations, which is organizations like the Karan Alliance Epic, Cerner that’s that’s big news, Microsoft and others.

[00:31:39] Participating organizations will agree to offer individuals with digital access to their vaccination records using the open inter-operable smart health cards, specifications based on the W3C verifiable Prudentials and HL seven fire standards, according to VCI. So essentially what you’re talking about here is we [00:32:00] are we’ve, we’ve solved the first problem, which is where are you going to track this?

[00:32:04] And we are going to track it in the EHR. We’re going to track it wherever we, we track it. And my guess is your, your motion. That’s going to be an EHR. Okay, great. Now we need to the person shows up for the first the first dose of the vaccine. They need to get the second dose, then don’t go back to the same place.

[00:32:24] They need to show that they’re they’ve had the first dose. We need to get that information sort of interoperable. [00:32:30] That’s what this is about. This is about using fire to go in and get that information to be able to move it around. Also put it on your mobile phone via the smart health cards specification, and be able to move it around.

[00:32:44] It’s I’ll tell you. What’s interesting to me is you’re hard pressed to find a place where Cerner and Epic are in collaboration. And what I mean, they make announcements all the time that [00:33:00] make, make it appear like, Hey, we’re working for the good of the community, but this is one of those cases where they, they are absolutely working for the good of the community.

[00:33:10] We have all the things that have happened around this, like 21st century, cures, fire, fire, really making a move forward. Plus the urgency of COVID coming together to create the perfect storm for all right. Let’s see if we can do something. If we can build. A mechanism for sharing this information and getting it into [00:33:30] the hands of the, of the patient.

[00:33:32] This is a, I think this is a potential game changer because for years we’ve been saying, Oh, we we can’t share that information. This is too hard. But if they’re able to do this, doesn’t that mean we’re going to be able to do an awful lot of other things coming out of this. 

[00:33:47] Anne Weiler: [00:33:47] It does it. I mean, the, I think the question is the value of the data to the health system.

[00:33:57] It sort of feels like vaccination data [00:34:00] is not that valuable. 

[00:34:02] Bill Russell: [00:34:02] Are you saying that the health systems will put up a fight if there, if it if it hurts their competitive advantage? 

[00:34:10] Anne Weiler: [00:34:10] Yeah. That’s what I’m saying. I’m saying many, many of the protectionist data policies in the past have been because they think that the patient’s data is their IP, which I completely disagree with and always took that stance of like the patient owns the data about their health and, and [00:34:30] they give technology companies like, well and and doctors permission to use it. The, the health systems, actually, they say they own the data and they give the patient permission to see it.

[00:34:50] So I think I’m sort of thinking like with vaccination data, it’s not that sticky. Like we don’t, you don’t think, Oh, I got vaccinated [00:35:00] at this place. It was such a great experience. I’m going to get all my vaccinations there. You get to wherever it’s most convenient. So it, it will set up the technical infrastructure. I don’t know if it’ll change the behavior 

[00:35:11] Bill Russell: [00:35:11] well, but here’s, I don’t think it will change the behavior either, but here’s what it does set up. So. We have the transparency rule, which puts the shoppable services out there. So we have a new set of data that we can put into the hands people. We are going to prove the ability to move this data out and move it around.

[00:35:28] And then the question becomes [00:35:30] the federal government keeps pushing this is the first set of data that you’re going to have to expose the, a fire. And then it’s the second set that third set and. Potentially, what we get to is, is a situation where I can finally move from place to place, not be really captive to where my data is being housed.

[00:35:51] I can move with my data and then you’ll see different plans start to emerge within the community that I think is the, the [00:36:00] hope. Again, I mean, I, the thing I love about this is. A different focus, different emphasis, but see CMS and HHS has been consistent now for the better part of almost two decades in terms of their desire to get the data into the hands of the patient, to empower the patient.

[00:36:21] We can argue whether it will and what we have to do to the data to get. Patients engaged, but [00:36:30] they’ve been pretty consistent now. And I don’t think that’s going to change under the next administration. I think it’s the emphasis might change. The emphasis might go from creating a, a market under the Republican administration to maybe Medicare advantage for all under the Biden administration.

[00:36:49] But at the end of the day, I don’t think this, this view of how data has been locked up and needs to be freed up. In order to support cures in order to support [00:37:00] cost reduction and those kinds of things. I don’t think that’s going to change at all do you. 

[00:37:04] Anne Weiler: [00:37:04] I don’t know. It’s just, it’s not going to be fast.

[00:37:08] What’s interesting is I actually remember, and I don’t know, I haven’t even say whether they exist anymore, but there were like startups doing backseat. Vaccine records for kids. Cause it was so hard to keep track of that for parents, which seems like a fee should be a feature of EMR portal. So yeah, there’s no question that the [00:37:30] piece of paper is not a good way of tracking. 

[00:37:34] Bill Russell: [00:37:34] Yeah, absolutely. So, so Anne, what do, do you have a story or anything to, to that you want to throw out there?

[00:37:46] Anne Weiler: [00:37:46] Okay. This may be going a little too far, but I think it’s pretty interesting. And this is again, it’s from a personal story, but as we’re talking about vaccine rollout friend of mine [00:38:00] was telling me about what was happening in France and that, so what’s happening in France is it’s cultural. They are sending out the notifications of you can get the vaccine and then they’re giving people like two weeks to decide if they would like it.

[00:38:21] And so it’s, they basically, I think by the end of last year, they had vaccinated 130 people. But [00:38:30] it’s a complete cultural, like It should be up to the individual to decide, and we’re going to make this equitable. And instead of saying here’s your appointment date? And if you can come or not, but your appointments going away, they’re like actually giving them this time.

[00:38:45] And as a result, they’re not actually rolling out the vaccine. So yeah. When we see the things happening on evenly in the U S I think we’re doing a better job jump from last year. 

[00:38:56] Bill Russell: [00:38:56] Yeah. We’re doing a better job, but you know, this, [00:39:00] we’re not going to have this conversation, actually, we’re coming up to the close of the show, but this is rolling out a vaccine in the age of social media is is another hurdle in and of itself.

[00:39:13] I mean the what is, what is accurate information? I mean, the number of times I have to answer questions to people that I’m like well, that’s common knowledge. It’s like, well, it’s not common knowledge because half the stuff they’ve read or our corner of the stuff they read is [00:39:30] contradicts what I’m saying to them.

[00:39:31] Anne Weiler: [00:39:31] Yeah. Yeah, no, I think it was more that just that you, you said you don’t want to federal rollout, that’s an example of a federal oil that was not working very well, but also I think goes back to the, you can design whatever program you want, but so much of it is the people are the, and the cultural aspects. Are the things that can screw up. That was my bigger point there. Yeah. 

[00:39:58] Bill Russell: [00:39:58] Right. And so you’re saying [00:40:00] in for, to be culturally relevant in France. They should distribute the vaccine in wine. So if they had a wine that was actually the vaccine. 

[00:40:09] Anne Weiler: [00:40:09] Well, maybe my, maybe my cafe idea is the right one 

[00:40:12] Bill Russell: [00:40:12] Cafe cafe as well. That would be, that would be true. It’s funny. Anne thanks again for for joining me. I appreciate it. And we’ll we, we we’ll do this again in about six weeks. 

[00:40:27] Sounds great. Thanks. 

[00:40:28]What a great discussion. [00:40:30] If you know someone that might benefit from our channel from these kinds of discussions, please forward them a note. They can subscribe on our website thisweekhealth.com or you can go to wherever you listen to podcasts, Apple, Google, Overcast, that’s what I use. Spotify, Stitcher. We’re out there. You can find us. Go ahead, subscribe today or send a note to someone and have them subscribe. We want to thank our channel sponsors who are investing in our mission to develop the next generation of health IT leaders. Those are VMware, Hill-Rom and Starbridge Advisors. Thanks for [00:41:00] listening. That’s all for now.

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