Newsday – Vaccine Logistics, Project Governance, and the Risk and Rewards of APIs
March 8, 2021

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March 8, 2021: It’s Newsday with Drex DeFord and Bill. Drex had a hip replacement. How was his patient experience? Bill is doing the show from Arizona. What’s it like traveling on a plane during Covid? Are people being stringent with their mask wearing? Does it feel safe? The Johnson and Johnson vaccine is almost upon us. How does the hacking of Pfizer and Moderna COVID-19 vaccine data affect public health? The demand for cybersecurity roles is through the roof. Are healthcare CIO’s willing to step into that position? Microsoft has done the hokey pokey with healthcare 3 or 4 times now. Are their new virtual care, RPM and care coordination cloud updates their best move yet? And Boston Children’s, Harvard, the CDC and Castlight have made it easy for you to find a nearby vaccination site with vaccinefinder.org. 

Key Points:

  • You don’t want to wear a mask one more day than you have to, but you don’t want to take it off one day earlier than you should [00:09:20] 
  • The US can do 3 to 4 million vaccines a day [00:10:35] 
  • Drex discusses his new role of Executive Healthcare Strategist at CrowdStrike [00:21:51] 
  • Are healthcare CIO’s willing to step into a cybersecurity role? [00:24:45] 
  • Approov hacked 30 mobile apps and found all of them to be vulnerable to API attacks. And some allowed access to electronic health records. [00:27:45]
  • Microsoft streamline the virtual experience for patients [00:37:53] 
  • Meet Sophia. Banner Health’s patient persona. [00:46:16] 

Stories:

Newsday – Vaccine Logistics, Project Governance, and the Risk and Rewards of APIs

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Newsday – Vaccine Logistics, Project Governance, and the Risk and Rewards of APIs

Episode 374: Transcript – March 8, 2021

This transcription is provided by artificial intelligence. We believe in technology but understand that even the smartest robots can sometimes get speech recognition wrong.

Bill Russell: [00:00:00] [00:00:00] Welcome [00:00:05] to This Week in Health IT. It’s Newsday. My name is Bill Russell, former healthcare [00:00:10] CIO for 16 hospital system and creator of This Week in Health IT, a channel dedicated to [00:00:15] keeping health IT staff current and engaged.

[00:00:17]Special thanks to Sirius Healthcare, Health [00:00:20] Lyrics and Worldwide Technology who are Newsday show sponsors for investing in our mission to [00:00:25] develop the next generation of health IT leaders. We set a goal for our show. And one of those [00:00:30] goals for this year is to grow our YouTube followers. We have about 600 plus [00:00:35] followers today on our YouTube channel. Why you might ask? Because not only do we produce [00:00:40] this show in video format but we also produce four short video clips from each show [00:00:45] that we do. If you subscribe, you’ll be notified when they go live. We [00:00:50] produced those clips just for you the busy health IT professionals. So go ahead and check that out. 

[00:00:54][00:00:55] Last week I keyed you in on something that’s unfolding here at This Week in Health IT. We started [00:01:00] off with our influencer podcast a little over three years ago, but since then we’ve been able to introduce [00:01:05] Newsday and Solution Showcases and last year, We expanded even further with our daily [00:01:10] COVID-19 series.

[00:01:11] And now we have a daily show Today in Health IT and I’m happy to [00:01:15] say that we’re not done growing yet. We have something really exciting happening here at This Week in [00:01:20] Health IT. Our goal, as you know is to help inform, educate and train [00:01:25] health leaders. And we understand lots of people take information in in different ways.

[00:01:30] [00:01:30] That’s why we’re introducing written content to our site for the first time. You’ll be able to find [00:01:35] news write-ups covering each of our shows in detail as well as feature stories. And I’m [00:01:40] really excited about the feature stories. We’ve hired two great feature story writers and they’re going to [00:01:45] take topics that are highly relevant to you and relevant to our [00:01:50] industry.

[00:01:50] And they’re going to turn them into feature stories on our website. I’m so thankful for all of our listeners [00:01:55] and the conversations that we’ve had our sponsors and the dialogue that we’ve had [00:02:00] in the back and forth has really convinced me that this is the best next [00:02:05] step. I want to thank all of you for listening and joining with us on our journey of raising up the next [00:02:10] generation of health leaders by amplifying great thinking to propel healthcare forward. Now [00:02:15] onto today’s show. 

[00:02:16] All right. Today we have news day and we have, we’ve got a lot of stuff. [00:02:20] We have our friend Drex DeFord on the on the show today. Hey, Drex. How’s it going?

[00:02:24] Drex DeFord: [00:02:24] Good, [00:02:25] good. It’s early here in Seattle but I’m happy to be on. 

[00:02:28] Bill Russell: [00:02:28] And you know, the first thing I noticed [00:02:30] is you have a better lighting, a new setup, and you look. You look [00:02:35] fantastic.  I mean you redid your studio. 

[00:02:38] Drex DeFord: [00:02:38] I did. I changed it up a [00:02:40] bit. Got some new gear maybe look a little bit better [00:02:45] because, you know, last Wednesday I had a total right hip replacement which went [00:02:50] fantastically. I don’t know if you I’ve tweeted a couple of videos of like just walking around the day after [00:02:55] surgery.

[00:02:55] It’s incredible what they can do with this tech. And so I’m feeling yeah, I’m [00:03:00] feeling good and yeah life is good. 

[00:03:03] Bill Russell: [00:03:03] Wow. So [00:03:05] you’re walking around. All right. I assume you’re doing physical therapy and whatnot. 

[00:03:09] Drex DeFord: [00:03:09] I will have [00:03:10] my first PT appointment this week. I think Thursday, I have my first [00:03:15] PT appointment.

[00:03:16] Bill Russell: [00:03:16] Wow. When my parents, so my mom had a hip replacement. [00:03:20] When she had that done. It was painful. I mean, and it was, it was months [00:03:25] it wasn’t months, but it was at least a month of physical therapy before she was walking pretty [00:03:30] well. 

[00:03:30] Drex DeFord: [00:03:30] Yeah, it was. I mean, it’s amazing to me. We I [00:03:35] went in at six in the morning on Wednesday last week, they did surgery started at eight.

[00:03:39] They did [00:03:40] a spinal block and then kinda knocked me out so that I wasn’t present for [00:03:45] the performance. And then they got, I woke up, I think [00:03:50] probably around 9:30, PT showed up, got me out of bed. We [00:03:55] walked a loop around the unit over some stairs and did it [00:04:00] all with sort of crutches. And everything was totally, [00:04:05] totally fine. Put my clothes on. They discharged me. I was home [00:04:10] by a little bit afternoon. I was walking around pretty normally, except for [00:04:15] stairs by that later that day and sort of two days post-op I was doing, [00:04:20] I literally did. Two miles, two days postop outside. I mean, I sort of ditched the [00:04:25] cane and everything right away.

[00:04:26] Cause it seemed to be more of a pain than it was helpful. And by [00:04:30] probably the third day I was doing the stairs with both feet, you know, going up and coming down. I mean, I’m being [00:04:35] ginger, I’m being careful, right. Bone has to grow into these new [00:04:40] implants and make them, you know, solid and make them work. So I’m not doing anything crazy, but [00:04:45] I’m definitely, I’m definitely moving and, you know, taking care of the wound site and doing [00:04:50] all the good compliance stuff that I’m supposed to do as a patient. So it’s crazy. It’s [00:04:55] amazing to me. I mean, I totally, if things stay on track and, you know, knock on wood, everything stays on [00:05:00] track, but I kind of think by the, you know, by April I’ll be you know, it could be snowshoeing and hiking again.

[00:05:05] [00:05:05] Bill Russell: [00:05:05] Yeah. You’re a youngster. I mean, to have. I mean, is it [00:05:10] sports related? 

[00:05:11] Drex DeFord: [00:05:11] It’s, a lot of it is sports, right? I mean, you know, I I have [00:05:15] done. I don’t even know several marathons, tons of [00:05:20] half marathons. You know, I’ve been [00:05:25] a very avid club cyclist. I’ve been in several bike [00:05:30] crashes. I’ve been in a helicopter crash that kind of gave me a nice snap on the right hip at one [00:05:35] point.

[00:05:36] And you know, all of that is, you know, my surgeon [00:05:40] essentially kind of went through the story with me and he was like, yeah, you know, whatever, you have like 700,000 miles on a, [00:05:45] you know, on a 500,000 mile hip it’s it doesn’t matter. You know, [00:05:50] when it happens and it’s been painful for like six years, it’s been going on, the arthritis has just been [00:05:55] killing me.

[00:05:56] And I got to the point where I was having a hard time sleeping at night. And dude, it’s. [00:06:00] It’s amazing. It’s incredible. The difference, the chain you have [00:06:05] kind of like a hip problem. You’ve been thinking about doing this. Yeah. [00:06:10] Just go do it. It’s pretty awesome. 

[00:06:12] Bill Russell: [00:06:12] So quick shout out. Which health system did [00:06:15] you go to?

[00:06:16] Drex DeFord: [00:06:16] I went to Swedish [00:06:20] Providence and they did a really amazing job. Of course, we’re always super [00:06:25] sensitive to how everything works from the intake to how many [00:06:30] times they check to make sure that they’re doing surgery on the right side to [00:06:35] even when I rolled into the or checking all the gear, how’s everybody gowned, you know, what kind of [00:06:40] gear do you have in there?

[00:06:40] They actually use a robot to do part of the work so that you’re, you know, you wind up being [00:06:45] aligned probably better than you are with original equipment. Ultimately when they’re done [00:06:50] and I mean everybody was fantastic. PT, OT, the [00:06:55] nurses, the facility you know, it was, it was great. The Swedish [00:07:00] orthopedic Institute just literally like four blocks away. I walked up that morning to have [00:07:05] surgery. 

[00:07:06] Bill Russell: [00:07:06] And it’s Swedish was a phenomenal [00:07:10] acquisition or acquisition by Providence. It’s such a great team. [00:07:15] So I need to apologize a little bit. I’m actually outside. I got on an airplane for the [00:07:20] first time since March 1st of last year. 

[00:07:22] Drex DeFord: [00:07:22] Wow. 

[00:07:23] Bill Russell: [00:07:23] Have you been on an airplane?

[00:07:24] Drex DeFord: [00:07:24] I have [00:07:25] not. I have not. 

[00:07:26] Bill Russell: [00:07:26] So, you know, I talked about [00:07:30] my time at DisneyWorld. Cause people wanted to know, Hey, you know, what was it like? And, and, you know, [00:07:35] social distancing everybody with a mask, I felt as safe as I could possibly feel. 

[00:07:38] Drex DeFord: [00:07:38] That was a great story. I’m so glad you [00:07:40] wrote that too. 

[00:07:41] Bill Russell: [00:07:41] Yeah, it was interesting, but I do not feel the same about getting on a plane.

[00:07:46] [00:07:45] Drex DeFord: [00:07:46] I can see it. Tiny little enclosed tube with recirculated [00:07:50] air.

[00:07:50] Bill Russell: [00:07:50] I know tiny little enclosed tube, there’s no checks, right? So there’s no [00:07:55] tests if you have COVID. There’s no, they don’t even do temperature checks. Cause they’re like, I don’t [00:08:00] know for what, for whatever reason, they don’t even do that. Everybody has to wear a mask in [00:08:05] the airport and on the plane but you get on the plane and you realize they’ve sold [00:08:10] every seat.

[00:08:10] Yeah. There’s no social distancing at that point. I mean, they’re not even far [00:08:15] enough if you’re aisle and aisle you’re still not far enough away. 

[00:08:18] Drex DeFord: [00:08:18] There’s people behind you in front [00:08:20] of you too. So you’re kind of surrounded.

[00:08:23] Bill Russell: [00:08:23] And they must’ve said about, I don’t [00:08:25] know. I mean, again, I went from one side of the country to the other I’m in Phoenix today.

[00:08:30] [00:08:30] And they must have said it about 30 times on it, on the PA system, [00:08:35] you know, please pull your mask up over your nose, down below your chin, you know, covered [00:08:40] completely. But you had kids on the plane, you had people trying to eat and that kind of [00:08:45] stuff. Right. And I looked at my wife when I got there and I’m like, the only reason we [00:08:50] are flying today is it has nothing to do with safety. It has everything to do with [00:08:55] just the economy would just completely shut down if we weren’t flying. And I [00:09:00] think what the other thing I saw flying to Phoenix, although it’s not just flying to Phoenix, our flight to St. [00:09:05] Louis was full. Our flight from St. Louis to Phoenix full and [00:09:10] the airports were full. And I sorta looked at that and said, I think [00:09:15] people are a little rammy they’re they’re getting to a point where they want to get out [00:09:20] there. And, you know, I was just talking to somebody who said [00:09:25] he saw a quote that said, I don’t want to wear a mask, you know, one more day than I [00:09:30] have to, but I don’t want to take it off one day earlier, or I should.

[00:09:35] [00:09:34] Yeah and I think we might be airing on the one day before we [00:09:40] should at this point. Cause we are making a lot of progress. We’ve seen a lot of positive things around [00:09:45] the vaccine. We’ve seen a lot of positive things around the trends. I’m sure you’re watching the numbers like [00:09:50] I am. 

[00:09:50] Drex DeFord: [00:09:50] Yeah. I mean, it’s amazing to me like we hit 2 million or two and a half [00:09:55] million vaccines yesterday, something like that delivered. [00:10:00] And I did some math, you know, I did some math early on. Maybe the last time we talked now is super [00:10:05] concerned. I’m like, Holy cow, like a million, a hundred million vaccines in a hundred days. [00:10:10] I mean, that still is like years worth of work. That’s not going to cut it.

[00:10:13] We got to get to like two [00:10:15] and a half, 3 million, three and a half million per day to be able to just [00:10:20] stay, you know, even and there’s been a lot of development since then, but [00:10:25] that number was for me. I was just like, Holy cow, there’s no way we’re going to get 3 million [00:10:30] vaccines a day, but now it looks, I mean, it totally looks like we might actually be able to pull that off.

[00:10:34] We can [00:10:35] probably do 3, 4 million vaccines a day. And with the new Johnson and Johnson [00:10:40] vaccine. And there was an announcement this morning. I think that Merck was going to help Johnson and Johnson actually [00:10:45] manufacturer their vaccines. That’s the whole machine is going to go even faster than we expected.

[00:10:51] [00:10:50] I’m with ya. I mean, I think everybody’s antsy and everybody wants to [00:10:55] get out but there is definitely the like, look we’re not, it’s not done [00:11:00] yet. And there there’s still very ends and there’s still a lot of things we don’t know is to keep doing what you’re [00:11:05] doing. Wear your masks and wash your hands and, you know just [00:11:10] think about the risks that you’re taking, not for yourself, [00:11:15] but for everybody around you.

[00:11:16] People like me who need to have a hip surgery. Right. I mean, I don’t [00:11:20] need outpatient surgery shutdown. Right. So 

[00:11:22] Bill Russell: [00:11:22] Are you, are you vaccinated? 

[00:11:24] Drex DeFord: [00:11:24] I’m not, [00:11:25] I’m not. I will. And my route in my head right now to get [00:11:30] vaccinated is you know, I’m not 65. [00:11:35] Healthy. I don’t, I’m like, you know number 99 out of a [00:11:40] hundred in line right now in the normal line which means hopefully that would [00:11:45] be July or something.

[00:11:47] The thing I have going for me is that I do have some [00:11:50] medical training, I can give shots and at the very least I can direct cars at [00:11:55] clinics and help people register and do walk-ups. So in my head, I’m thinking right now that [00:12:00] once I’m kind of cleared by, you know, post-op and PT, that I may very well go [00:12:05] volunteer at a clinic for, you know, for giving shots.

[00:12:08] And that may be a way for me to get [00:12:10] vaccinated earlier. 

[00:12:11] Bill Russell: [00:12:11] So the biggest challenge I’ve heard, and I’ve heard this from several [00:12:15] health systems, in fact we’re recording the show early because I’m [00:12:20] actually off this week. I’m in Phoenix. That’s the sound in the background is a, [00:12:25] that the is on the golf course so everybody can feel sorry for me. [00:12:30] My wife and I took a trip out here to visit some friends and whatnot, but the [00:12:35] you know, the, so tomorrow cause we’re recording this Tuesday before this [00:12:40] will actually go live. Tomorrow I’m going to release the show I did with Sarah White. Sarah White [00:12:45] is in charge of innovation at UCHealth which is University of Colorado.

[00:12:49] And they [00:12:50] published that playbook, that 55 page playbook on mass vaccinations. And [00:12:55] you know, we recorded the whole show and then we got get done. And this always happens by the way I stop [00:13:00] recording. Then I ask a question that I thought, man, I should ask this question. I’m like, so, you know [00:13:05] the biggest challenge is really getting the vaccine. And [00:13:10] the crazy thing is UC health ed had a partnership with the state and all these entities, [00:13:15] and they didn’t know they were, they had a mass vaccination plan, the whole playbook written, [00:13:20] ready to go. They didn’t know until about four or five days before the event that they were going to [00:13:25] get the 10,000 vaccines to actually administer the vaccines for their mass vaccination event.

[00:13:30] [00:13:30] And I’m like, man, how did you do that? So the thing of this T minus [00:13:35] five. They get the notice. Yes. We’re going to have it. Now you have to schedule everybody. You have like two days [00:13:40] to get everybody scheduled. 

[00:13:41] Drex DeFord: [00:13:41] 10,000 people.

[00:13:42] Bill Russell: [00:13:42] And all the logistics set up. So you know the [00:13:45] tents and all the people lined up at the, and I’m like, man, that’s [00:13:50] I was even more impressed, but that I say that story to say, I’m [00:13:55] hearing this over and over again.

[00:13:55] I know health systems that don’t have enough vaccine or [00:14:00] even when they’re told, Hey, you’re going to get 2000 doses of the vaccine. It doesn’t arrive [00:14:05] on the day they think it’s going to arrive. Well, you’ve scheduled people and you have things going. That’s one of the [00:14:10] problems I’ve heard from people. And the second is the [00:14:15] experience, the user experience, or for scheduling the vaccine.

[00:14:20] [00:14:20] Sub par is what people are describing as you log into the [00:14:25] portal, you go through this questionnaire and then it tells you, I’m sorry, we don’t have any appointments. And they’re [00:14:30] like, okay. So what do I have to do the next night? Well, you have to log into the portal, go through the questionnaire [00:14:35] before you know that they don’t have any appointments.

[00:14:38] And that user [00:14:40] experience is lacking. And I think Epic has come out with something around that. There’s now a [00:14:45] thing called a vaccine finder. I shared that with you. The vaccine. [00:14:50] And so that’s a partnership with CDC, Boston Children’s. [00:14:55] I’m sure our friend John Brownstein was involved in that somehow.

[00:14:58] Drex DeFord: [00:14:58] Absolutely was. 

[00:15:00] [00:14:59] Bill Russell: [00:14:59] And and Harvard and Castlight. And so you could hit this [00:15:05] site now, vaccine finder.org, put in your zip code and it’ll tell you what places [00:15:10] around you actually have availability of the vaccine. Now [00:15:15] they’re going to follow CDC guidelines. So, you know, me calling it, my age is not going to help [00:15:20] at all, but I was curious so I put it in there and I saw Walmart and I saw others.

[00:15:24] So I, [00:15:25] I made a phone call. I was like, do you really have the vaccine? It’s like, yes, we do have the vaccine. And I’m like, [00:15:30] so I imagine there’s some variability on the [00:15:35] you you know how accurate the information is because it’s going to be dependent on. [00:15:40] You know the info. I don’t know where they’re getting the information.

[00:15:42] I’d love to know where they’re getting the information, but [00:15:45] they had identified places in our area. And I know there’s people who are waiting to get the [00:15:50] vaccine in our area that probably don’t know that they can go to [00:15:55] vaccine finder.org and find a place that’s pretty close to them. I don’t know about you guys, but [00:16:00] there’s still people in our area driving my gosh, they’re driving hundreds of miles to get [00:16:05] the vaccine. 

[00:16:05] Drex DeFord: [00:16:05] Yeah, I think, you know, people are people we’re [00:16:10] still in the phase right now, where there are tons of people who want the vaccine. So that’s not a problem yet. I [00:16:15] mean, we will eventually get to the, toward the end where we’ll have people who will say, no thanks. I’m not [00:16:20] interested. And that will be a whole education, you know, [00:16:25] social connection trying to convince people to take the vaccine the last, [00:16:30] whatever, 30% or 20%. But there are definitely people who want the vaccine right now [00:16:35] and are doing back flips to try to get it including, you know, lying and cheating and stealing to, you know, [00:16:40] dressing up as old ladies to get in line nine, to try to get the vaccine. We’ve seen all of those stories [00:16:45] too. 

[00:16:45] Bill Russell: [00:16:45] Are you kidding me? Is that really? 

[00:16:46] Drex DeFord: [00:16:46] Yeah. Yeah. Yeah. There were a couple of folks in Florida in your home [00:16:50] state that were detained. I don’t know if they were arrested. I think they were [00:16:55] charged on some kind of public disorderly, you know, something I’m not sure, but had dressed [00:17:00] up like older folks that had somehow gotten the first shot and had come back for the second [00:17:05] shot and you know, so that there are things like that, [00:17:10] that yeah.

[00:17:12] There are things like that that bother me because I know there [00:17:15] are people who are more deserving and should be at the front of the line that should actually be getting it. And at the same time, [00:17:20] there’s a part of me that is just like, just everybody get the vaccine so [00:17:25] that the guys at the back of the line, like me, it’s good for me too.

[00:17:28] The more people that get the vaccine, the [00:17:30] faster they get it, the better protected the people who can’t get the vaccine are so [00:17:35] you kown I’m not advocating, lying, cheating, and stealing. I mean, I think there’s plenty of [00:17:40] ways for, if you want to do some work, you can probably move up at least a few notches in the line.

[00:17:44] But [00:17:45] yeah, people are doing things they’re not supposed to do to try [00:17:50] to get the vaccine at this point. 

[00:17:51] Bill Russell: [00:17:51] Well the other thing I’m hearing, and by the way, we’re going to get into some cybersecurity [00:17:55] stories and that kind of stuff. But the other thing I’m hearing, cause we did a, I mean Sue Schade and I talked about vaccine [00:18:00] for about 40 minutes last week and it was good and it was great, but people might be getting [00:18:05] tired of us talking about vaccine.

[00:18:08] But regardless, [00:18:10] you know, the you know, Pfizer requires [00:18:15] the coolers. And so there’s a lot of horse trading going on at this point as well. Of people [00:18:20] going, Hey, look we, we can’t really take the Pfizer vaccine because we can’t store it, [00:18:25] but we can take the Moderna vaccine. Well the J and J vaccine doesn’t have this requirement [00:18:30] really at all. And it’s a single shot vaccine. So if you have if you [00:18:35] have the J and J system and Merck [00:18:40] system producing the vaccine, I have a feeling we’re going to, we’re going to have an overproduction here [00:18:45] shortly and the single shot it’s going to make the logistics that much easier. 

[00:18:49] Drex DeFord: [00:18:49] Oh, it [00:18:50] changes everything, changes, everything. And I mean, especially in places where [00:18:55] you know, you’ve read some stories lately about rural America where [00:19:00] there’s, you know, literally a nurse and a car driving [00:19:05] around, you know, wherever Iowa, South Dakota hundreds of miles [00:19:10] per day to get to little towns where there’s only 35 people. And you [00:19:15] know, when you, when part of the logistics of that is that I have to keep this stuff at [00:19:20] Sub-Zero temperatures.

[00:19:21] And, you know, I have to come back again for sure in two weeks to make sure [00:19:25] that I get everybody a second shot or three weeks to make sure the logistics are way more [00:19:30] difficult. And so with something like Johnson and Johnson would be able to go out and just plug a [00:19:35] town in and then, you know, drive away and not worry about them again for awhile. That’s changes [00:19:40] everything. 

[00:19:40] Bill Russell: [00:19:40] So let me ask you this question, and this is just one of those mind exercises that you [00:19:45] play, but let’s, so whenever you hear logistics, you think of who are the best logistics [00:19:50] companies in the world? It’s UPS, it’s Amazon. So let’s just take UPS and Amazon. [00:19:55] Let’s assume we said, all right, we’re going to do mass vaccinate. We’re going to do [00:20:00] vaccination of the United States through our logistics companies. And let’s start, let’s just [00:20:05] go with Amazon. How do you think Amazon? What would of the process look like? If, and I know [00:20:10] we wouldn’t have done this, but let’s just assume we went to Amazon said, look, you’re in charge of getting everyone [00:20:15] vaccinated.

[00:20:15] Yeah. What do you think that would have looked like? 

[00:20:18] Drex DeFord: [00:20:18] I mean, I tweeted about this a [00:20:20] few weeks ago, but the idea that, you know, you could have gone to somebody like Amazon and written a contract [00:20:25] that basically said you have to vaccinate, this, you know, this [00:20:30] many Americans and you can lay it out by area.

[00:20:32] However you want it to design the contract and that you [00:20:35] have to hit that number, or we don’t pay you. Right. So you put some hardcore incentives in [00:20:40] there. You know, if you vaccinate more than this, you get a bonus, you set it up sort of [00:20:45] financially to make it really, really attractive to a company like Amazon and you let them go to town.

[00:20:49] And I [00:20:50] think, you know, with all the logistics that they have and the ability that they’ve had to sort of figure out how to [00:20:55] order something online and have it delivered two hours later, they would have [00:21:00] figured out how to have done all of that. And I think that would have even maybe [00:21:05] meant taking a medical assistance and putting them on Amazon trucks and [00:21:10] going around neighborhoods to let people, you know, come out to the truck and get your vaccine.

[00:21:14] I don’t [00:21:15] know what it would’ve looked like, but you know, there’s, it’s a pretty [00:21:20] interesting idea that you could have just handed all that logistics off to a real logistics [00:21:25] provider and not, you know, just sort of kept the States informed. It would have been a whole different way of doing it. [00:21:30] But, you know, it is a loss of control.

[00:21:32] It’s a loss of control for Statesthat [00:21:35] need to feel like they’re doing something and all of this too. 

[00:21:38] Bill Russell: [00:21:38] Interesting. So our lead story for [00:21:40] today is that Drex DeFord is now with CrowdStrike. Is that our lead story? No, it’s our leady story but we’re going [00:21:45] to, we’re going to start there. So congratulations on your new role. What is your new role [00:21:50] with CrowdStrike? 

[00:21:51] Drex DeFord: [00:21:51] I am the Executive Healthcare Strategist for CrowdStrike. And so [00:21:55] that’s a you know, I know for some people that’s a bit of a head scratcher. CrowdStrike had been a client of [00:22:00] mine and Drexio, my independent consulting firm a few years ago as they stood up [00:22:05] the healthcare vertical.

[00:22:05] And a lot of that was just to help them build their healthcare [00:22:10] team, help them better understand having a place that can go to ask questions about how do we talk about this, or [00:22:15] how do these products fit into other things that are happening in healthcare. And I felt really [00:22:20] comfortable with that team the whole time.

[00:22:22] And you know, I don’t know, they weren’t [00:22:25] ready. I wasn’t ready. It wasn’t a good you know, specific match at the time. [00:22:30] So I went off and did other things, but I continued to stay in touch with them. And just before Christmas [00:22:35] they came back and said we think we’re ready now. And you know, [00:22:40] we hammered out the details and it’s going to be interesting and [00:22:45] fun. I work with the healthcare team but also with work with public sector team [00:22:50] government and you know, higher education, all of that whole whole [00:22:55] group, but I’ll be really mostly focused on healthcare. And a lot of it is going to be you know, [00:23:00] sort of pre-sales stuff, a lot of thought leadership kinds of things, raising CrowdStrike’s profile in [00:23:05] healthcare. But a lot of it also will be certainly working with existing customers, potential [00:23:10] customers, working with the team and title inside of CrowdStrike to make sure that we’re building products that work for [00:23:15] healthcare and do the things that that they have already really demonstrated [00:23:20] that they can do.

[00:23:21] Just figuring out the right ways to be able to talk about those [00:23:25] inside the healthcare sector. So it’s a lot of stuff. It’s honestly a [00:23:30] bit of a job that is part utility player and [00:23:35] part. I’m going to be figuring it out on my own, which the entrepreneurial [00:23:40] part of this also is very attractive to me too.

[00:23:41] It’s not a job that somebody else had [00:23:45] and that person left and they hired somebody new it’s in a lot of [00:23:50] ways for me to come in and do some. Creativity in a company that has a huge [00:23:55] amount of resources and can really help me with that. 

[00:23:58] Bill Russell: [00:23:58] Yeah, no, that’s, you know, here, [00:24:00] here’s the news of that, to be honest, and it’s a great hire and I’m not just saying that it is a great hire [00:24:05] for them to bring in someone like yourself.

[00:24:08] I mean, you really understand the healthcare, [00:24:10] know all the players and those kinds of things. And I realize you’re working on more than just that, but [00:24:15] anyway, I think it’s a great hire. the, I think the news of that [00:24:20] is I’m seeing it more and more. So I, in the role I’m in now I get the phone call.

[00:24:24] I get [00:24:25] not the, Hey Bill will you come work for us? But more along the lines of, Hey, we’re looking for [00:24:30] somebody that sort of looks like this, you know, of anybody. And [00:24:35] you know, your, you went to CrowdStrike, Karl West went to Sirius and another [00:24:40] company called me up and said, Hey, we’re looking for a healthcare CIO or a [00:24:45] former CIO who’s willing to step into cybersecurity role. Now, the thing I [00:24:50] thought was interesting about that role is it had it really came with a sales quota which [00:24:55] I thought, I mean, my first comment to them was, I’m not sure a CIO is gonna [00:25:00] jump out of their current role to take on a sales quota, but you know [00:25:05] I’ll think about it and I’ll take a look at it.

[00:25:06] So that my data point is since [00:25:10] January 1st all those things have happened, Karl, you and that [00:25:15] phone call. And I think a lot of organizations are trying to figure out with all [00:25:20] the cybersecurity ramifications of the attacks of late last fall. And the [00:25:25] shutdowns are trying to figure out, okay, how do we help healthcare?

[00:25:28] And we [00:25:30] need more insider knowledge of what are they struggling with? How, how can we better [00:25:35] position our products? And how can we have better conversations with healthcare? To meet [00:25:40] those needs. I think that’s, I think that’s the story of you going in there to be honest. 

[00:25:44] Drex DeFord: [00:25:44] You know, [00:25:45] the other thing for me is that even as an independent consultant, I [00:25:50] continued to sort of, there was one cybersecurity gig after [00:25:55] another cybersecurity gig, as part of the work that I was doing as an independent consultant, [00:26:00] and I could see where some were falling down and some were doing well. And what I really saw, you [00:26:05] know, overall in the market is that, especially as we got into the pandemic there were [00:26:10] lots of things that we wanted to do that were super cool and interesting from telemedicine to digital [00:26:15] health, to consumerization healthcare, we’re buying new stuff and connecting it together.

[00:26:19] We’re getting [00:26:20] pressure from the government to share data. And we, and there were lots of problems in all of that. [00:26:25] And you know, to me, a lot of it came down to where can I go? [00:26:30] That you know, not to pump the company, but you know, are doing a really good job that gives [00:26:35] me a really long crow bar to help be able to sort of lift healthcare up and put them in a better [00:26:40] position to be able to do all the things that they want to do around digital health [00:26:45] and consumerization of healthcare and all the other things that we have on the list because [00:26:50] you can do in a Maslow’s hierarchy of needs kind of way, you can do all the cool things you want, but if you [00:26:55] don’t have that base layer resolved around cybersecurity and lots of other things, but [00:27:00] specifically cyber security.

[00:27:01] And we just, you know, we got our butt handed to us in [00:27:05] 2020 from a cyber perspective. There were, you know, every day there was a [00:27:10] new story and it just seems like there has to be a better way to do that. There aren’t enough people, [00:27:15] health systems are super stressed. Patients and families are worried about [00:27:20] the things that they should even tell their doctor, because they’re afraid the data will get away from the health system.

[00:27:25] [00:27:25] This is a terrible situation. We’ve got to get out of that. We’ve got to resolve it. And [00:27:30] so 

[00:27:30] Bill Russell: [00:27:30] Which leads us to, I can help that leads us to our first story. So our first story is [00:27:35] mobile health apps, mobile health apps, leak sensitive data through APIs. [00:27:40] And I wanted to talk to you about this. I covered it in today and I put it on my LinkedIn post, [00:27:45] a company called Approv A P P R O O V.

[00:27:49] That’s what happens when [00:27:50] we run out of domain had you know, essentially went in [00:27:55] white hat, white hat, kind of hacked 30 mobile apps, and here’s what they found. [00:28:00] All of the apps, all they were found to be vulnerable to [00:28:05] API attacks and some allowed access to electronic health records.

[00:28:08] The 30 apps collectively [00:28:10] exposed 23 million mobile health users, two attacks a night reported of the [00:28:15] 30 app tests that 77% contain hard-coded APIs of [00:28:20] which some do not expire according to the report at 77% [00:28:25] had a barcoded username and passwords. I went as far as my today show is to say [00:28:30] if you find an API that has hard-coded username and passwords, you should fire it as find and [00:28:35] fire those people immediately and get rid of those companies immediately.

[00:28:38] I mean, we [00:28:40] learned that in high school, our first programming class we ever take, you [00:28:45] learn not to hardcode username and passwords into code. And so if people are [00:28:50] wondering why I’m being so adamant on that, I mean, that’s like  [00:28:55] that’s an  egregious proble. But anyway we’re fighting these problems and I’m afraid of [00:29:00] what people are going to take from this.

[00:29:01] is oh see APIs are bad, we shouldn’t be going down this fire route. [00:29:05] And you know, all we’re doing is exposing all the data. And I don’t think that’s the moral of this [00:29:10] story. I think the moral is a story is we’ve got to get better at this. At [00:29:15] identifying these things, understanding how the API has work, understanding how [00:29:20] a complete security stacks can work around a set of KPIs and [00:29:25] recognized just because, you know, there’s a need to connect things up you still [00:29:30] have to put that security framework around every connection that you’re making. 

[00:29:35] [00:29:35] Drex DeFord: [00:29:35] Yeah. I mean, API is, are cool. Right? They, you know, back [00:29:40] in the day we had to write interfaces between all of these things and they were miserable and they were hard to write. And then [00:29:45] every time somebody upgraded system on one side, we had to rewrite the interface and they were, you know, [00:29:50] like but livestock, it was a terrible situation.

[00:29:53] And then somebody came up with APIs and it [00:29:55] seemed like initially it was like, that’s amazing because now it’s almost like you have a power strip and you can [00:30:00] plug these things in and they can all communicate with each other. And I don’t have to worry about [00:30:05] the way the data flows back and forth because these API is take care of all the sort [00:30:10] of transfer of that data, which is great until, you know, like [00:30:15] after for APIs, we started to see things like this. You know, hard-coded passwords, [00:30:20] hard-coded usernames and lots of other things just sloppy coding and [00:30:25] these APIs. So they worked but you know, at the same time we started to be, you know, [00:30:30] really concerned about the way that they worked. [00:30:35] And even today, I mean, I don’t know, two weeks ago I was working [00:30:40] with at the time a client who was working with another potential client [00:30:45] and they were talking about exchanging data through an API. And when we looked at the API, you know, it [00:30:50] was like, I mean, it was like, you know, baby’s first API, you know, it was like, it was an [00:30:55] API.

[00:30:55] It was certainly written and could certainly exchange data but there were a lot of things in there that [00:31:00] it didn’t make it super comfortable to to [00:31:05] use. And so you’re exactly right. The point on APIs is that like [00:31:10] everything, they come along, they’re bright shiny objects, and they seem to save the day.

[00:31:13] Yay. Silver [00:31:15] bullets. And then you start to look inside and there’s corrosion. It doesn’t work the way that you think it [00:31:20] should work. Just expect that for everything that you’re going to see, because it’s going to happen more and more and [00:31:25] faster and faster. As we continue to get into this digital health world, there’s going to be more [00:31:30] super cool things are going to work great. And the government’s going to fall in love. And they’re going to tell health systems that they have to [00:31:35] use them. And then companies like Epic are going to step in and say, wait a minute, wait a minute. I’m not [00:31:40] sure I’m concerned about all these APIs and they’re going to get trash thrown at them.

[00:31:43] And look, [00:31:45] this is the thing we’re going to have to work through over time. They’re not perfect. They’re not, they’re awesome, [00:31:50] conceptually, but you gotta make sure you spend some time under the hood and they work the way that they’re [00:31:55] supposed to. 

[00:31:55] Bill Russell: [00:31:55] Yeah. Well, we’ve meandered early on in the show. So I’m going to rifle through some stories here.

[00:32:00] [00:31:59] So the let’s see, this is from Becker Health IT. A [00:32:05] new dimension of broad six cybersecurity execs weigh in on vaccine data hacks. And so I don’t know if you [00:32:10] saw this. In January, the EMA European medicines agency conferred [00:32:15] that some of it’s data from pharmaceutical companies regarding their COVID-19 vaccines and treatments had [00:32:20] been leaked  online.

[00:32:21] Howeve  before posting the information, the hackers manipulated the data [00:32:25] in a way that could undermine trust in vaccines the EMA said. In [00:32:30] February reports began to surface that South Korea’s national intelligence service accused North [00:32:35] Korea of attempting to hack the Pfizer system. And it goes on. And then what they did is they pose the [00:32:40] question how does a situation such as the hacking of Pfizer and Moderna COVID-19 vaccine data [00:32:45] affect public health. And what does this mean for the future of healthcare cybersecurity? And they [00:32:50] asked Curtis Cole, who’s a physician assistant, vice provost of information [00:32:55] services, and CIO at Weill Cornell medical college.

[00:32:58] And he had a really cool answer. I just want to [00:33:00] read through it real quick and have you comment on it. There are two aspects of this. [00:33:05] I find fascinating first, this is a new way to perpetrate. [00:33:10] Perpetuate. Yeah, the problem of deep fakes, I thought it was [00:33:15] perpetrate, but it’s perpetuate the problem of deep fakes.

[00:33:18] We have been anxiously [00:33:20] discussing how to protect from AI driven sake, images, videos, and news. And [00:33:25] while the problem of fake data and fake research is not new. This presents a new dimension of fraud. [00:33:30] This isn’t a misguided scientist passing off a fake result, rather [00:33:35] they are trying to undermine source data that legitimate researchers might want to [00:33:40] use.

[00:33:40] So that’s one aspect of it. The second aspect is that this is [00:33:45] only important because of increased learning of scientific discourse which [00:33:50] was confined to the protective sphere of like-minded researchers were public [00:33:55] discourse where it is inevitably simplified and taken out of context, social media then [00:34:00] accelerates the transmission of misunderstanding.

[00:34:02] So this is certainly concerning, but I [00:34:05] take some solace in the fact that researchers are also trying to create legitimate [00:34:10] synthetic data to protect privacy. That turns out to be really hard. So this fraud [00:34:15] may not be easy to replicate either. So it’s interesting his [00:34:20] perspective on this in terms of, you know, why is a [00:34:25] hacker using the data in this way. It really does. [00:34:30] It is to undermine our trust in the information that we’re reading [00:34:35] and seeing this is, you know, cybersecurity [00:34:40] is one of the most fascinating areas that we have going, because it’s not just about, [00:34:45] you know, keep them in, keep them out, they’re stealing their information, they’re selling their information.

[00:34:49] Now it’s becoming. [00:34:50] They’re changing how we view information in society.

[00:34:54]Drex DeFord: [00:34:54] [00:34:55] Which undermines trust for entire segments of our society [00:35:00] that used to be the most trusted. Right. I mean, his point about deep fakes, I mean, it’s an [00:35:05] interesting analogy, right? And that you watch a video now and you can’t really, for sure there’s a lot of [00:35:10] videos that you see now that that they are saying, you know, they’re telling you, this is a deep fake, but boy, that shirt really [00:35:15] looks like Tom cruise saying whatever crazy stuff that was being said on the video. And [00:35:20] this same idea of sort of taking databases like that and [00:35:25] going in, and maybe either, either downloading them and then manipulating the data so that it [00:35:30] turns out the government, or, you know, the [00:35:35] CDC is saying this thing is 90% effective, but they manipulate just enough data so that when [00:35:40] they release it to the public, Hey, here’s something you didn’t know.

[00:35:42] We got the database and you should look at this. [00:35:45] It says it’s only 10% effective or something right now. Who do you believe? [00:35:50] Well, this is, you know, that’s the whole point. It can be a nation state trying to undermine the [00:35:55] confidence that we have in our own processes and things that really do work. [00:36:00] They could steal it for money.

[00:36:02] You know, some of the biggest labs in the world don’t [00:36:05] actually have any wet labs. They don’t actually do that kind of lab work. What they have is lots [00:36:10] of databases from lots of places that they bring together. And they use that data in new [00:36:15] and interesting ways to discover things that no one else has discovered.

[00:36:19] These are [00:36:20] truly massive data labs. You start monkeying with some of the data that [00:36:25] comes from some of these other sources and you can have those organizations announcing [00:36:30] discoveries that aren’t legitimate when you actually go back and look at it. So if the [00:36:35] point of this in many ways is to destabilize our confidence [00:36:40] in government, healthcare organizations, [00:36:45] universities, research institutions.

[00:36:48] It’s a good [00:36:50] but terrible strategy. And yeah, we’ve already, we’ve already [00:36:55] as Americans sort of exposed ourselves as being very willing to [00:37:00] accept information from other places that isn’t necessarily legitimate. 

[00:37:05] [00:37:05] Bill Russell: [00:37:05] Yes. Let’s hit Microsoft. So your neck of the woods. [00:37:10] Microsoft updates cloud for healthcare with new virtual care patient monitoring features.

[00:37:15] [00:37:14] So I, you know, I’ve often said that Microsoft is an arms dealer, they’re an arms, you know, [00:37:20] they’ll give you they give the the organizations, the [00:37:25] tools they need to be successful. Right. So and they don’t care who they’re selling to they’ll sell the [00:37:30] competitors and those kinds of things. The tech giant announced its cloud for healthcare services [00:37:35] back in October.

[00:37:36] That brings together existing services, such as Microsoft Teams, Azure, [00:37:40] IOT, and chatbots to help healthcare organizations manage operations. The first update will be [00:37:45] available in April and include services for care plan management and we’ll support eight additional [00:37:50] languages. Virtual health. He goes on to talk about virtual health.

[00:37:53] We’re introducing new [00:37:55] dynamic 365 patient access features to streamline the virtual [00:38:00] experience for patients by allowing more flexibility in self-scheduling both virtual and [00:38:05] in-person appointments through their existing patient portal and integrated virtual assistance [00:38:10] like Azure health bot service, or triaging scheduling and making it seamless to [00:38:15] receive follow-up and wellness guidance from their care team he wrote. So this is the thing I [00:38:20] always find interesting about Microsoft. I think people [00:38:25] in Kansas city and and Madison right now [00:38:30] are looking at this going, where are they going? And you know, one of the [00:38:35] challenges with the EHR for years is, and we’ve been trying to explain this.

[00:38:40] [00:38:40] It’s not a CRM. It is not a customer relationship management [00:38:45] system. And because of that it has gaps. It has gaps in [00:38:50] how you interact with the with people who aren’t patients [00:38:55] in your community and how you, you know, how you do things with that population. [00:39:00] And so you can’t deal with customers.

[00:39:02] You can only deal with patients from an [00:39:05] EHR. Well in steps, Microsoft, and they start to build around [00:39:10] Dynamics, which is a true CRM. They start to integrate things like their chat bots, like [00:39:15] their video tools and teams and whatnot. And now you start to see [00:39:20] this pretty comprehensive looking vision that’s coming out that [00:39:25] obviously can overlay on top of the EHR, but it’s not hard in my mind to [00:39:30] fast forward and think of taking whole sections of the EHR and [00:39:35] replacing them with code in the future.

[00:39:37] Now I understand as duty will say [00:39:40] you know, people who say, you know, this stuff, isn’t rocket science and these people have been [00:39:45] down this path before, and haven’t been able to really replicate the EHR, but I’m not [00:39:50] talking about re replicating the wholly HR. I’m talking about overlaying it, bringing the data [00:39:55] in, using it, moving it back and forth, and those kinds of things.

[00:39:58] And that is the last [00:40:00] hurdle that these kinds of companies like Salesforce [00:40:05] and Microsoft, and even you know, some other players that are out there. [00:40:10] We’ll have to, and even Google for that, for that matter will have to overcome is the [00:40:15] movement of data back and forth through the EHR. If they ever get through that barrier.

[00:40:20] [00:40:19] I think it’s the best thing that could happen for health systems and healthcare, and that you will [00:40:25] open up to a whole new world of applications [00:40:30] and use of data for care. Now again, with great [00:40:35] with great The power comes great responsibility, and we’ll [00:40:40] have to go down that path in the future. But. What are your thoughts?

[00:40:45] [00:40:45] Drex DeFord: [00:40:45] It’s interesting to see, you know, Microsoft has sort of done the hokey pokey with healthcare now three [00:40:50] or four times. And I think this, this time is kind of interesting because maybe it’s a little bit [00:40:55] different. I don’t know that they’re necessarily building products specifically for healthcare. What they’re [00:41:00] doing now is that they have taken products that they already have, and [00:41:05] they have, they’re now spending a lot of time to try to figure out how do we take these products and wrap them [00:41:10] around other existing healthcare processes to make those processes [00:41:15] better for patients and families, better for providers, whatever the case may be. [00:41:20] So it’s really, like you said, taking tools that they already have seeing and [00:41:25] understanding where gaps are in healthcare, data and engagement with patients and then figuring out how they use [00:41:30] those tools to sort of fill those gaps.

[00:41:31] That’s different from, I think previous [00:41:35] approaches that they’ve tried to take with healthcare. And it’s [00:41:40] probably the one that they, you know, have the most likelihood of being successful [00:41:45] with because it’s not really inventing brand new things for healthcare. It really is using products that [00:41:50] they already know and love using have explored and deployed in other industry [00:41:55] and just figuring out how to fit them to a very complicated [00:42:00] healthcare world. 

[00:42:00] Bill Russell: [00:42:00] Yep. And I don’t people will walk away saying Bill says Microsoft is going to build an HR because [00:42:05] that’s not what I said. What I said is they’re an arms dealer. They’re going to enable someone to build an EHR. [00:42:10] And they’re going to have, they’re going to give a whole bunch of tools and that kind of stuff, not that health systems are [00:42:15] going to run out and do that nor should they, but they’re going to [00:42:20] create an opportunity to do an awful lot of really cool things.

[00:42:22] I’m going to end on this story. So Kaufman [00:42:25] Hall did their report. Yeah, and it was [00:42:30] it was commissioned by the aha American hospital association. [00:42:35] And they essentially created two scenarios, a optimistic and a [00:42:40] pessimistic scenario where essentially health systems and the year that we’re [00:42:45] currently in 2021, we’ll lose between 53 billion and $122 [00:42:50] billion due to the pandemic.

[00:42:52] And a lot of that’s just due to [00:42:55] the changing. Behaviors of people and how [00:43:00] they engage in healthcare. It’s interesting to me [00:43:05] and we’re going to take a health IT perspective with us, cause we’re not going to talk about the financials. I’ll do [00:43:10] that later when I have Rob DeMichei back on to talk about, but [00:43:15] for you and I, from an IT perspective, here’s what I’m hearing from CEOs I’m [00:43:20] hearing it’s essentially everything’s ramping back [00:43:25] up is what I’m hearing. All the projects that were put on hold are starting to ramp back up. The COVID [00:43:30] projects are there as well as you know, even some new projects that are [00:43:35] starting to come out like these mass vaccination events and those kinds of things.

[00:43:41] [00:43:40] How are we going to [00:43:45] you know, how are we going to not lose focus going into [00:43:50] the timeframe that’s coming up. I, you know, we, one of the things that [00:43:55] these losses indicate is that we’re going to have to do more with less, and we have [00:44:00] just as much, if not more projects coming our way you know, what’s the best way [00:44:05] for it. Staff and managers and CEOs to to [00:44:10] stay focused. 

[00:44:11] Drex DeFord: [00:44:11] I mean, it’s ultimately comes down to governance, right? It [00:44:15] comes down to setting priorities and doing a good job of having a process to make sure that you’re [00:44:20] implementing the things that your partners in the provision of great health care to [00:44:25] your patients and families who are doctors and nurses and lab and pharmacists, whoever the case may [00:44:30] be.

[00:44:30] You’re not implementing projects for you. You’re implementing projects for them. If you have a good governance [00:44:35] process, that process should. Be one that causes them [00:44:40] to prioritize and de prioritize projects. Your job then becomes [00:44:45] to make sure that you make a coherent argument about the [00:44:50] resources that you have, or you don’t have to not only be able to execute the projects, but run them [00:44:55] after they’ve been deployed, continue to run them well, and do all of that on a.

[00:45:00] [00:45:00] Relatively simple, relatively modern infrastructure that is secured. And if [00:45:05] you can tell that story, you will be successful. And if you can compel your counterparts at the [00:45:10] big table to do their part around prioritization, you will be successful. But [00:45:15] That sounds really easy. And I have spent [00:45:20] years and I can tell you it is not a simple it’s not a simple [00:45:25] thing.

[00:45:25] You’ve seen it in lots of other places too, but governance is a challenge [00:45:30] setting priorities at work. Somehow our brain works really differently than it does [00:45:35] when it comes to setting priorities at home and making a decisions about buying a new car or going on [00:45:40] vacation or paying the mortgage. Right. We think differently about this at work for some reason.

[00:45:45] [00:45:44] And so we struggle with it. But if you can put the discipline in place and make [00:45:50] that machine run, you will be more successful than the other people you’re competing. 

[00:45:56] [00:45:55] Bill Russell: [00:45:56] Yeah. I agree. I accept, you know, governance to me is the, [00:46:00] nlet’s call it the stick approach. The [00:46:05] carrot approach to me is if you can get ahead of the story and you alluded to this in [00:46:10] your answer. If you can set the narrative, [00:46:15] what are we trying to do?

[00:46:16] And so I’ve seen effective organizations do this. [00:46:20] At Banner they came up with a persona of Sophia. And Sophia [00:46:25] is a woman of a certain age with some kids and one on the way and whatnot. [00:46:30] And they actually had a model and they took pictures of her and the cardboard cutouts around the [00:46:35] health system.

[00:46:36] And so when people have a conversation around a project, it’s how does this help [00:46:40] Sophia and what, yes, it has a way of a narrative has a way of of [00:46:45] focusing that the energy of the organization. Right. And I remember when Erin Martin came into [00:46:50] healthcare at Providence he organized around the [00:46:55] expecting mom. And his concept was really simple.

[00:46:59] He was like, look, [00:47:00] moms, make you know, or what the number is. And I’m, so I’m going to make something up like [00:47:05] 90% of all healthcare decisions for the families. And the expecting mom is going to have a family [00:47:10] by definition. She will have this family and she will take that role and she will [00:47:15] manage the majority of those conversations.

[00:47:17] I remember him talking about that. And [00:47:20] so what it did for there, I remember him talking and when I heard it, I thought. That is [00:47:25] a, that’s an organizing narrative or what’s important. And so a lot of the [00:47:30] projects that initially came out of the, their innovation group over there was [00:47:35] around that persona in that person.

[00:47:38] And so there is an opportunity. [00:47:40] I mean, governance is the way we project intake and pay. Are we focused on [00:47:45] those kinds of things, but there’s also a narrative approach that if the, and by the way, this has to be the entire [00:47:50] leadership, it can’t just sure it has this. Absolutely. But if you can get the entire [00:47:55] leadership team to organize around a, a narrative of some kind, [00:48:00] then you have a better chance of not getting overwhelmed over the next.

[00:48:05] [00:48:05] I don’t know. You’re the two years where they say. Hey, we’ve got to do all these [00:48:10] projects and it feels like there’s no priorities and it just all has to get done. 

[00:48:14] Drex DeFord: [00:48:14] I mean, that’s what mission, [00:48:15] vision values is kind of all about, right. Is the thing that we’re doing the thing that’s [00:48:20] going to get us closer to the target idea that we have for [00:48:25] our health system. I’ve become a big fan of this guy, James Clear, who [00:48:30] has written lots of books and does, you know, lots of speaking stuff, but I mean his own point, his whole [00:48:35] point even about us personally, is that every decision that we make, we have to think about. Am I [00:48:40] making that decision because it makes me closer to the person that I actually [00:48:45] want to be.

[00:48:45] And if your answer is, yes, you should do that thing. And if your answer is no, you really [00:48:50] have to sort of question like why you’re putting time and energy into that same, that same [00:48:55] concept expands across, you know, individuals and teams and health [00:49:00] systems and entire industries. Are we closer to the thing that we want to be.

[00:49:04] Bill Russell: [00:49:04] Yep. [00:49:05] Well Drex as always great conversation. I’m sorry for all the outdoor noises. I’ve got [00:49:10] wind blowing across my microphone. I have no idea how this is going to sound.  

[00:49:12] Drex DeFord: [00:49:12] It’s awesome. It sounds good. You know, [00:49:15] it’s going to be, it’s going to be fine. 

[00:49:16] Bill Russell: [00:49:16] Lawn mowers in the background. Just rubbing it in for all those [00:49:20] people.

[00:49:20] Drex DeFord: [00:49:20] The sun in your face.

[00:49:21] Bill Russell: [00:49:21] Yeah, actually I’ve a heat, I have a gas heater on [00:49:25] behind me. I’m freezing. So if it looks good, it looks legit. [00:49:30] Yeah. It’s a, Phoenix is a desert but it gets really cold at night. [00:49:35] People don’t recognize that, but it’s it’ll warm up to about 70, 75 [00:49:40] degrees today, but I miss Florida where it was 85 when I left.

[00:49:44] Drex DeFord: [00:49:44] Well, Hey, two [00:49:45] terrible places to be when it comes to weather. Right. So good for you. 

[00:49:48] Bill Russell: [00:49:48] Yeah, well, we’ll see what we can [00:49:50] do. Hey thanks again. Congratulations on your new role. And I look forward [00:49:55] to seeing you up and around again. Are you going to try to do the bicycling and running again? Or.

[00:50:00] [00:50:00] Drex DeFord: [00:50:00] As soon as I can get a back on the Peloton, I will be back on the Peloton. So [00:50:05] that’s kind of, I think at least mentally for me is going to be part of the PT. I’m looking forward to that. 

[00:50:10] [00:50:10] Bill Russell: [00:50:10] Fantastic. All right. Well, we will we’ll catch up again in about six weeks. 

[00:50:15] [00:50:14] Drex DeFord: [00:50:14] Sounds good.

[00:50:15]Bill Russell: [00:50:15] All right. That’s all for this week. If you know someone that might benefit from our channel, please forward them a note. [00:50:20] They can subscribe on our website this weekhealth.com or wherever you listen to podcasts. Apple, [00:50:25] Google, Overcast, Spotify, Stitcher, probably some other places that I’m not even familiar with. We want to thank our [00:50:30] channel sponsors who are investing in our vision to develop the next generation of health IT leaders [00:50:35] VMware, Hill-Rom, Starbridge Advisors, Aruba Networks and McAfee. Thanks for [00:50:40] listening. That’s all for now. [00:50:45]

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