May 21, 2021: Bill Russell has a candid conversation with Bill Spooner, retired CIO, long term member of the CHIME Opioid Task Force and Founding Advisor at Huntzinger Advisors. They go deep! Bill discusses his 35 years at Sharp. What were the greatest cyber threats back then? What was the level of telehealth adoption compared to what it is now? So many waivers and additional reimbursement opportunities emerged during the pandemic. Should we be worrying that we’ll never get healthcare costs under control again? What is the concept of digital thrust? Quantum computing has the potential to upset even the most sophisticated cybersecurity strategies we’re putting in place. It also gives us the ability to do research at a level we’ve never even considered before. Where is all this taking us? What will healthcare look like for the patient 10 years from now?
Recovering CIOs Discuss the State of Health IT
Episode 406: Transcript – May 21, 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] Thanks for joining us on This Week in Health IT influence. My name is Bill Russell, former healthcare CIO for 16 hospital system and creator of This Week in Health IT, a channel dedicated to keeping health IT staff current and engaged.
[00:00:17]Today we are joined by Bill Spooner, retired CIO. Spent 35 years at Sharp.
[00:00:23] Special thanks to our influence show sponsors Sirius Healthcare and Health Lyrics for choosing to invest in our mission to develop the next [00:00:30] generation of health IT leaders. If you want to be a part of our mission, you can become a show sponsor as well. The first step is to send an email to [email protected]
[00:00:39] Just a quick note, before we get to our show, we launched a new podcast Today in Health IT. We look at one story every weekday morning and we break it down from a health IT perspective. You can subscribe wherever you listen to podcasts. Apple, Google, Spotify, Stitcher, Overcast. You name it, we’re out there. You can also go to [00:01:00] todayinhealthit.com. And now onto today’s show.
[00:01:02]Today we are joined by Bill Spooner, retired CIO. Spent 35 years at Sharp. 35 years. Bill. That’s an awful lot of time to spend at one organization but it looks like today you’re hanging out in the country with your John Deere shirt on and for those who are listening to this, they’re not getting the full experience.
[00:01:21] You have the picture of the countryside behind you. You have the John Deere shirt on. You really look like a retired gentlemen at this point.
[00:01:30] [00:01:30] Bill Spooner: [00:01:30] Well I’m mostly retired at this point. Bill. I left, I retired from Sharp just about seven years ago. I’ve done a bunch of interim leadership roles and advisory roles and different capacities since then.
[00:01:46] Haven’t done much lately with the pandemic. We’ve pretty well hunkered down here in Northeast, Tennessee after I finished an interim CIO stint last summer. But I’m [00:02:00] leaning more towards retirement now.
[00:02:01] Bill Russell: [00:02:01] Yeah. So you’ll still take those phone calls and still offer your service. You’re still doing stuff with CHIME as well.
[00:02:08] Bill Spooner: [00:02:08] Oh yeah. Well there’s a couple of things that you, you get passionate about. I’ve been a part of the CHIME opioid task force since it was formed three years ago. And you know, when something like that happens when one of your friends loses a loved one, it really does motivate you to do everything you can to help the rest [00:02:30] of the world.
[00:02:30] And so I’ve been pretty active with that and I’ve been chairing the most wired program with CHIME since its inception, since CHIME took it over. And I find that really interesting. It helps me to stay current. No the last two years when we created these levels within the most wired rankings we wanted to validate that the top tier of the level 10 ranking.
[00:02:54] And so the first year I went out on site to three great organizations. And so if they [00:03:00] were doing, and that just fantastic in terms of understanding the latest and greatest in HIT. Last year we did them virtually and we had another half a dozen candidates and that participated in a bunch of those. And so it was really nice. Just kind of what the world is about.
[00:03:16] Bill Russell: [00:03:16] Yeah. It’s pretty cool program. I looking forward to having you on the show and, and this discussion as, as you know, I talked to CIO’s and you know, there are topics that you just aren’t able to get [00:03:30] into with active CIOs, and I’m hoping we can go a little deeper on some of these things since you are retired and
[00:03:39] Bill Spooner: [00:03:39] Fire me, go ahead and say whatever you want.
[00:03:42] Bill Russell: [00:03:42] All right. Well, all right. Let’s, let’s start with cybersecurity. You know, there’s a lot going on with cybersecurity and this is really getting serious. If you think about your time before you were retired, what’s the greatest threat that, that your health system faced with regard to cybersecurity?
[00:04:00] [00:04:00] Bill Spooner: [00:04:00] Well, to do confessions, we actually did have a breach. In 2006, it was determined by the FBI that had been a Russian hacker. Fortunately for us, it must’ve been a Russian hacker in training because they didn’t get much. And we were able to determine that we didn’t have to go public. They didn’t add an access to any sensitive information, and we knew exactly how they got in.
[00:04:28] So it didn’t scare us as [00:04:30] much as it might today. But we had a, we started a six cybersecurity program and with the turn of the century initially based upon HIPAA, and then it started growing over time. I would say that when I left Sharp, it was more a case of planning for something that we didn’t ever really think would happen. And the debate was with the caregivers about their.
[00:04:56] How quickly their screen was to shut down and things like that because [00:05:00] they hadn’t heard of significant breaches and it wasn’t real to them yet. In the past several years, you bet it’s real. And whereas I was kind of viewing it as a necessary evil back then I’m almost, I’m just super passionate about it today with some of the opportunities I’ve had since then I’ve seen different security programs, different philosophies of the security leadership, everything from [00:05:30] a small shop that is so confident that nothing is ever going to hit them, that they just are almost cocky about it. And I just said, well, I hope and pray that you’re right to some organizations that are extremely well organized in their cybersecurity programs. Very well disciplined. You just, you see it, everything from soup to nuts, they do bet. It’s just, it’s a serious thing today. You know, we were observing last September when university of Vermont med [00:06:00] center was offline for a month. Well my former friends at Scripps health in San Diego are in their 12th day right now.
[00:06:08] And that’s pretty scary. And you got to think about not just the impact on getting the ID program back in line. How about the patients that are trying to get care? I’ve seen some comments on Facebook patients that don’t know whether their surgery is really going to happen or not per schedule. And then trying to find out how to reach [00:06:30] somebody to a, an old patient, trying to get their records transferred to a, to another center for some specialized procedures.
[00:06:39] And how do I get to them? You’re pretty well dead in the water without those computers these days.
[00:06:43]Bill Russell: [00:06:43] So how do we get ahead of this as an industry? So if we brought you back as a CIO and seeing what you’re seeing now, where they can take you offline for 12 days or 10 days or whatever it is, I mean, how do, how do we get ahead of this?
[00:06:58] Bill Spooner: [00:06:58] Well, first of all, I can tell you, there are a lot of [00:07:00] people smarter than I am, but, you know, I really do think you’ve got to take it seriously and one of the, one of the things we’ve seen in the financial world, this we’ve been audited forever. And I would say that having been through financial audits, they’re not that rigorous. I think that organizations need to be ready to subject themselves to an external assessment. Whether whether it’s annually or every two years, you gotta do, you gotta take it seriously.
[00:07:25] In the first of the year, there was a safe Harbor provision in the [00:07:30] law for organizations that are using NIST as their guideline. And just from what I’ve seen, there’s one thing to say you’re using NIST to actually rigorously following it and having yourselves evaluated in terms of how rigorous your security program is.
[00:07:49] You got it take us seriously. I’ve seen organizations that and I will say. I was on a board committee of a large health system with a very sophisticated [00:08:00] security program and almost in every quarterly report the CISO would recite almost every breach and fowls the compromise of privileged credentials.
[00:08:08]And multi-factor authentication comes in there. When you hear an organization say, well, the CEO doesn’t like to have to use two factor authentication. So we turned it off for them. That’s just the wrong approach. I mean, we have to have teeth in our cybersecurity programs.
[00:08:27] Bill Russell: [00:08:27] Yeah. You know, when I was CIO, we had [00:08:30] internal and external auditor. The internal auditor spent an awful lot of time on cyber security. And so it was almost on a at least on a quarterly basis, if not more often than that. I was sitting down with the internal auditor, looking at reports of various aspects of our cybersecurity plan and approach. And, you know, they, we had work plans.
[00:08:54]It was almost like we could dedicate a team to some of the things that they were doing, because they were constantly bringing [00:09:00] people in doing penetration testing. They were doing audits of our processes, audits of our maturity framework and those kinds of things. But a lot of health systems you know, again, we’re six and a half billion.
[00:09:12] So we have that level of oversight and scrutiny, but a lot of health systems haven’t had that level of oversight and scrutiny. So how, you know, how do we, how do you get that started? Where, how do you get going on that path?
[00:09:27] Bill Spooner: [00:09:27] Well, I think the unfortunate thing is that organizations [00:09:30] tend to increase their focus on cybersecurity after they’ve had a breach. But you’d have to hope that some would realize that when their neighbor has a breach that they should take that to heart as well. I think that you hate to ask to require some federal regulation, but if that’s what it takes, then that, that is what it takes. NIST is a very good framework.
[00:09:52] Some organizations use high trust and that’s an excellent framework as well. A lot of CISOs don’t like high trust because it costs [00:10:00] money. On the other hand, it is, it involves a rigorous external evaluation. Yeah. We need something to light a fire under us as an industry. And you know, even for small organizations. There are ways for them to get support.
[00:10:16] And it’s kind of interesting look at a big organization and they may have 50 different tools and a small organization can afford five. And it’s a question of affording, you know, taking the five that you can. They’re going to have the most impact. In one [00:10:30] I’ve seen in one organization doing a real serious phishing exercises, monthly, where they get really creative and try to really mask the source of the email and things like that.
[00:10:41]And then another organization that we’re. If you look at incoming email address and it almost looks the same every month it’s hard to hard not to catch it. So is it a really good, simulation? One organization that actually requires its employees to come and take a class if they failed [00:11:00] a couple of a phishing simulation.
[00:11:02]Bill Russell: [00:11:02] That’s interesting. I, you know, as we talk about this and I’m going to transition to telehealth it’s a good example of what the CIO has to deal with. It’s cybersecurity, foundational, operations, foundational performance and the systems foundational. And then on the flip side, the very next conversation is hey, what are we going to do around telehealth how are we going to advance the business?
[00:11:22] How are we going to, you know, fill in the blank? And so I expect our conversation to be a little bit of a taste of the [00:11:30] life of a CIO. So let’s talk telehealth a little bit. You you know, Sharp had a lot of covered lives. So you guys, that was probably part of your repertoire, but the level of adoption we saw last year was, astronomical, obviously during the start of the pandemic.
[00:11:43] And it has since come down a little bit. During your time there, what was the level of adoption of telehealth at Sharp?
[00:11:49]Bill Spooner: [00:11:49] Well I was there Bill, I would call it pilot. I think it was 2011 that the medical group Sharp Rees-Stealy began a program and to [00:12:00] have the providers call patients and these were established patients and go over their conditions on the phone to determine whether they really need to come into the office.
[00:12:07]And there was a real good use for that in that case, because large part of the business was capitated. So they’re getting paid anyway. They didn’t need to not have another office visit if it wasn’t necessary to get their income. And it started growing from there. and they were still working on it as I left. I think it was four years ago.
[00:12:26]They did a really nice presentation for Scottsdale Institute where they showed how [00:12:30] it had evolved and had moved into video visits in several areas and they were actually showing some ROI for it. And so I expected it’s even gone well well beyond that in the intervening time, I haven’t really checked in with them.
[00:12:45]But I remember seeing the Scottsdale presentation and sending some emails out, complimenting them because they had come in enormous away in that four year period.
[00:12:55] Bill Russell: [00:12:55] So some of the key to that is you guys have capitated lives. So you’re getting [00:13:00] paid for, the wellness of that population.
[00:13:02]And you’re taking risks where the wellness of that population. So as opposed to sick care, you’re not getting paid every time they come in and you’re getting paid on a monthly basis regardless. And so you guys started pretty basic. You started with, with just telephone calls, right? Telephonic hey, how you doing?
[00:13:19] Just following up, want to see how this is progressing? That’s where it started. And then that became the foundation for workflow and processes. And then we layered on. Some some of the [00:13:30] newer technology as it moved along, I would imagine.
[00:13:32]Bill Spooner: [00:13:32] As of a few years ago, they were using video visits, stroke care on a number of domains. And typically their approach was to adopt telemedicine where it made sense. I think that’s the dilemma that you have today. We saw during the early times of the pandemic that every visit under the sun was done by telemedicine because the only thing that you can do right. [00:14:00] Now we’re seeing some thought into the appropriateness of different types of telehealth visits.
[00:14:09] And I just read an article over the weekend with it was Dr. Peter Pronovost well-known physician leader, challenging whether tele health in some forms doesn’t compromise quality. I think that the industry is going to settle down on it. There’s there’s such a demand just like with almost any [00:14:30] new innovation.
[00:14:30] If you’ve got a hundred vendors out there trying to sell something. People are going to try to adopt it. And if some point you got to find the, you know, find what is reasonable. I had a couple of telehealth visits, right. One was good. One wasn’t good. And I think that leads to another element of it.
[00:14:46]A lot of the companies that are offering telemedicine where I can get any doctor. I just get a doctor is different from me having a tele health visit with my own established physician. [00:15:00] And I prefer the vehicle that’s with my established physician because we understand each other. I know the types of things for which she’s going to probably refer me to a specialist anyway, in which case I’m willing to do a tele health visit not to waste your time. And then she can send me out to the specialist. But then the other hand I have, when I had a persistent sore throat for three months, she had to look down my throat. She wasn’t going to be able to do a very good job with that with my [00:15:30] video visit.
[00:15:31]Bill Russell: [00:15:31] Yeah. I would imagine not
[00:15:32]Bill Spooner: [00:15:32] Some of that sorting out thats got to happen. I mean, we know that it’s going to be a permanent part of our repertoire. I read another piece just yesterday, the day before United healthcare, I’m a United healthcare Medicare advantage patient, and they were publicizing some brief bits about the use of telemedicine, what they recommended or didn’t. And their recommendation was in favor of [00:16:00] video visits and they discouraged audio only.
[00:16:04]Bill Russell: [00:16:04] Yeah. I mean, that would make sense to me. I mean, as a physician, you want to be able to see the person, but, from a what do we say, access challenge that we have from a disparities challenge that we have, not everybody has broadband, not everybody has access to potentially the video technology or at least stable video technolog to do the visit. And I guess that’s what we saw during the pandemic of [00:16:30] just, you know, a lot of the calls that failed, they failed because of a lack of technology or the lack of infrastructure in those locations for that. And we don’t, you know, we don’t think about it in major cities, but you’re are, you’re not in a major city anymore. You have pretty good broadband there?
[00:16:48] Bill Spooner: [00:16:48] Hi, this is my broadband is let me pray it’s working today. I have CenturyLink a good speed on minus seven megabits. It occasionally fails on me. I have [00:17:00] my iPhone here ready to turn on the hotspot if my CenturyLink fails and interestingly I can look out my window and see the Comcast cable wires down at the road.
[00:17:11]My three neighbors have Comcast, but my house was built since Comcast came into the neighborhood. They quoted me $84,000 to hook me up. No, I do not have good broadband.
[00:17:24] Bill Russell: [00:17:24] $84,000.
[00:17:28] Bill Spooner: [00:17:28] Yes. Not [00:17:30] bad. I’d send them up right away.
[00:17:32] Bill Russell: [00:17:32] Not bad. I mean not bad if you’re connecting up a new hospital, but connecting up your house, it’s a little on the steep side.
[00:17:40] I mean, is this one of the areas where the government is going to have to step in with infrastructure and help to help them build this out? Yeah, I would think so.
[00:17:49] Bill Spooner: [00:17:49] Go back to the incentives that came out in the first deck action in response to the pandemic, a lot of money came up, was put towards telehealth, but it was focused on the providers to buy the gadgets, [00:18:00] not to the areas to put in broadband.
[00:18:02] And it’s nice to hear that this year there is more discussion about broadband from noon, but I’m still not sure that it’s going to be enough because there’s a big broadband gap in the country.
[00:18:13] Bill Russell: [00:18:13] Yeah. It’s, it’s almost like the national highway system of all those years ago.
[00:18:17] I mean that, that almost needs to be the same kind of program and it needs to be built out across the country. Cause I don’t know how people function without broadband, it’s almost a prerequisite for anywhere we’re going to live. [00:18:30] And you know, how do you find a job today without broadband? How do you stay current, current events?
[00:18:35] How do you, there’s just so many things that require broadband and we’re creating this. I, as people say the digital divide, if, if we don’t address that. And I think that is one of the areas where the government could step in and provide some help that’s probably needed.
[00:18:52]Bill Spooner: [00:18:52] Help where it’s needed and as well as oversight and existing services, because the organizations that somewhat cast [00:19:00] themselves as public utilities are not doing a good job.
[00:19:02] Bill Russell: [00:19:02] Yeah. Well, talk to me about the pandemic. What do you think the long-term impact of the pandemic is going to be on healthcare and specifically healthcare IT?
[00:19:13]Bill Spooner: [00:19:13] Well I think that we will be we’ll have some version of remote workforce forever. It’s interesting that different organizations are approaching it differently.
[00:19:23] Some organizations I’ve talked to have actually abandoned their real estate to get rid of [00:19:30] office buildings, assuming that they will be permanently remote. Others are doing everything they can to bring people in on site. And I think reality is that there’s going to be some combination just to the basic workforce.
[00:19:44] The one thing that you hope happens. And we saw this up in Charleston when I was working up there last year, is that. In the case in time of crisis, you realize that you can make decisions a lot more quickly. And we certainly did that and you’d like to [00:20:00] hope that that can continue going forward because an amazing amount of work was accomplished.
[00:20:06] And you realized that the only obstacle in the past was just getting through that decision-making process and reaching agreement on how you’re going to configure XYZ and which one you’re going to do first. When crisis hits people realized that that standard of business. I mean, I, to say there’s one thing that I hope happens and [00:20:30] that’s it. One of the things that misses outside of HIT but I’m going to wander anyway.
[00:20:36] One of the things I worry about is that there’ve been so many waivers and additional reimbursement opportunities that have emerged during the course of the pandemic that I worry that we’ll never get healthcare costs under control. Again. Because we’ve all lobbied our favorite congressmen to get certain reimbursement privileges.
[00:20:57]The reimbursement levels for telehealth is a good [00:21:00] example. And I’m waiting for a couple of years to see how it levels off. Are we going to be still a little under 18%? We’ll be down to 60, or I fear we may be at 22 and. And given the federal budget situation that, that does not look good for healthcare because they’ll have to squeeze it some form or in some form or another.
[00:21:23] Bill Russell: [00:21:23] Yeah. It’s it’s interesting cost of healthcare. So from a health IT [00:21:30] perspective, you know, we’re responding to the business for the most part. If the business gets full reimbursement, Well at parody for a telehealth visit, I’d imagine there’s gonna be a lot of demand for telehealth within your organization.
[00:21:42] And you’re going to respond in doing that. Are there, things that health, IT could be focused in, on to drive down the cost of healthcare for the community that they live in?
[00:21:56]Bill Spooner: [00:21:56] I think that the work that’s being pushed hard [00:22:00] over the past few years to really achieve interoperability is going to bring good value. Just having information so that caregivers can make decisions. this a world of good. And, you know, not every community is going to be 100% ethics. So you’re not looking, you’re able to just look at one system, but those caregivers still need the information where I am.
[00:22:26] Our health system has just converted to Epic, but [00:22:30] most of its doctors are independent docs in the community. And I’ve got a record in two different versions of Allscripts, a Cerner remote. Next gen Athena health, your road chart. I didn’t realize they had an even HANA system dedicated for urologists and none of them talk to one another and you’re, but you are seeing a lot better exchange going on.
[00:22:58] There’s been a lot of pressure [00:23:00] in that as you know, and I think that’s going to bring some, some good value. I think if we start looking though at some of the. Innovations that are out there. And look at them thoughtfully. IT is going to help them. I sat through a webinar last week. That was a chime webinar, actually.
[00:23:20] And it was describing, you probably are already familiar with this, but it was called a reverse pitch. Where rather than [00:23:30] doing the usual thing where you’ve got a hundred vendors that we’d like to get in at five minutes, the CIO an organization describes this describes his biggest priority or its most severe problem and posts it in the form of a RFP type and asks organizations, vendor organizations, developers to propose solutions to it.
[00:23:54] And then they go with the ones on some kind of a risk-sharing [00:24:00] basis that look the most promising. And so that allows you to really focus problem and solution together. And that isn’t, that is an IT solution and it’s, but it’s enabled by the organization. I think that’s got huge promise if organizations truly follow it.
[00:24:17]Bill Russell: [00:24:17] Oh, so you’ve been in health IT 35 some odd years or more actually. You were at Sharp for 35 years. If I asked you to pull together your longitudinal patient record, do you think, how long do you think it would take you to [00:24:30] do that?
[00:24:30]Bill Spooner: [00:24:30] We won’t live that long.
[00:24:32] Bill Russell: [00:24:32] You’re complete longitudinal patient records. Well, I mean, given your age, probably a bunch of it’s in paper still, right? It hasn’t been digitized. If I think of my birth record, it’s probably not digitized. So there’s going to be paper and digital aspects of that. I mean, how hard is that to do?
[00:24:53] Bill Spooner: [00:24:53] I’d say it’s probably impossible because organizations will purge the records. But there’s a little bit of good news. Because I’m on two [00:25:00] versions of Allscripts here and at Sharp Rees-Stealy in San Diego. I was also on Allscripts, coincidentally both Sharp Rees-Stealy and the local providers went up on following my health on the same day.
[00:25:14] And I can actually see some of my history from San Diego on following my health still. And that helps. And I’ve used it a ton from time to time. Doc wants to, is interested in a certain lab readings and how’s that [00:25:30] happened over time. I’d pull it up and follow my health and show it to him. So that’s somewhat of a narrow scope of my longitudinal record, but it’s a start.
[00:25:41]Bill Russell: [00:25:41] It’s going to be interesting. You talk about purging records, but I mean, we were both in the state of California. We had to keep our records for my gosh. If I find I might get these years wrong, but I think it was 28 years. Or something like that was our
[00:25:56] Bill Spooner: [00:25:56] 26 or 28 in some cases. And [00:26:00] then the other issue was that when you look at looking at images, we didn’t really have early on a discrete way to purge specific images because you had to keep some images for the 26 years while others, you could might be able to get rid of and seven, but because you didn’t have the technology, you kept everything.
[00:26:17] Bill Russell: [00:26:17] Right. And it was, yeah, it was just easier. You didn’t want to risk it because long-term storage is pretty inexpensive at this point. Although the image sizes keep, keep getting bigger and bigger and bigger and [00:26:30] taking up more space. we were exchanging stuff in email, prior to this, and you threw out this concept of digital thrust.
[00:26:37] I’ve never heard it before. So what is this concept? Give me an idea of what digital thrust is.
[00:26:42] Bill Spooner: [00:26:43] It was referring to a bill as a, as marketing hype, right? Like you go to the HIMSS conference. There’s the term does your that the vendors are using to sell their products, whether it’s HIPAA or you name it and
[00:27:00] [00:27:00] Bill Russell: [00:27:00] Artificial intelligence
[00:27:02] Bill Spooner: [00:27:02] That is digital health. And I think I re replied in my response that. Ada Loveless and the other guy were working on the they call it the analytical engine back in the early 18 hundreds. And that was, that was ones and zeros. And so it’s always been digital. I find some cynical humor and all of a sudden it’s digital.
[00:27:22]Shout out to my pal Craig Richardville. Speaking with him back in 2014, he described to me [00:27:30] that all of their work was being done first on mobile apps and then on the web. And he felt that’s what we would be doing in five years everywhere. And he was right, but it was mobile apps.
[00:27:43] Within a couple of two or three years, then it’s digital health. And so instead of being a CIO, I’m a digital health leader. So my goal in life is to live well enough. I want to be the first quantum health leader as quantum computing becomes well.
[00:27:57] Bill Russell: [00:27:57] Let’s just make you that now you’re the first quantum health leader [00:28:00] that we’ve ever interviewed on the show.
[00:28:01] So I appreciate that. Let’s talk about the future. Quantum computing, AI data foundation. You know, we can, we can talk about where this is all going. I mean, data is a data analytics we used to talk about, you know, getting from reactive analytics, to predictive models for analytics. Now we’re getting into real-time predictive models for analytics and whatnot.
[00:28:27] You know, quantum computing has the potential [00:28:30] to upset even the most sophisticated cybersecurity things we’re putting in place, but also. Give us the ability to do a research at a level we’ve never even considered before. We’re where’s all this taking us. What does healthcare look like to the to the patient, you know, 10 years from now, patient 20, 20, 31.
[00:28:51] How are they going to be experiencing healthcare?
[00:28:53]Bill Spooner: [00:28:53] Well I think in 2031 there will be telemedicine established and we’ll be doing the smartest [00:29:00] things remotely. And we’ll probably have more. More patient devices. You know, I have a pacemaker as well, year and a half ago. And I fear the things that my cardiologist can know about me because it’s connected to the database in the sky.
[00:29:15] I had a call one time asking me to start taking a certain medication cause they thought some of my readings were off. I talked them out of it but that’s just the beginning. And as it relates to chronic care, I think that we’ll be [00:29:30] spending a lot less time in the doctor’s office themselves because we’re going to have those attached devices.
[00:29:35]But you mentioned analytics, I’m really impressed by what I’ve seen. You might come from the days where I did spreadsheets by hand in budget models, by doing alternate 13 column pads and watch them go into Quatro pro and Excel. And now you’ve got organizations like Epic that are playing that they have a hundred million patient records in their cosmos [00:30:00] database.
[00:30:00] I want, I’m not selling Epic. It’s just a good example. A urologist friend in San Diego, or 15 or 20 years ago, talked about having a patient with a really strange condition that he didn’t understand. And so he went on to English, pub med or some. Service and just started scanning through record by record, to find a patient that looked like his, and then finding the doctor and calling it the treating physician up to what did you do with this guy as opposed to now [00:30:30] being able to match your patient up with maybe a dozen other patients in this huge database thats got the similar conditions and here are the treatments that work best. It seems to me that there will be far fewer patient situations where you say, Oh, this is some esoteric disease that we’ve never seen before, because we probably have seen it before. I think that, that boat’s great for PA for the patient.
[00:30:59] Bill Russell: [00:30:59] Yeah. So we’re [00:31:00] going to be able to find matches based on a lot of different factors. I would imagine. I mean, Hey, here are the symptoms and whatnot, but you can potentially in the future, you can be looking at genetic markers and those kinds of things in real time to identify I dunno, I identify people that are similar in terms same disease state that you’re fighting and addressing those things.
[00:31:23]Just out of curiosity, where do you think innovation is going to come from? I mean, this is the age old argument we have. Health systems have innovation [00:31:30] arms there. They’re doing their part in the innovation world. Big tech is doing innovation. We have health tech, startups, and just all the money flowing into to healthcare startups and those kinds of things.
[00:31:44]Where do you envision that we are going to see a significant amount of innovation come from?
[00:31:49] Bill Spooner: [00:31:49] Well, I think, I think all of the above and I would rather than label it health systems versus anything else. It’s creative people. I know a couple of [00:32:00] CIO of small to mid-size medical groups that have their, this one person, font of knowledge. And then in a small enough environment, they’re able, they’ve been able to develop really interesting effective programs, analytics types of programs remote patient monitoring programs, because they were creative and clever, and they were able to convince their bosses that it was a good idea to try.
[00:32:28] So I would [00:32:30] say it’s more From a creative forward thinking organization, whether it be a, an insurance company or a health system or a large medical practice. It’s more, it’s more the attitude and the risk aversion state of mind to me that that will bring the innovation. There’s always going to be the vendor community.
[00:32:50] We know that the doctor’s not satisfied in practicing medicine because he thinks that his system, his organization doesn’t give him [00:33:00] him or her enough support and they go out and invent something. They will always be there. And it’s a question of matching all of the parties together and finding what works, finding the organization that’s willing to take the risk on them. And as you know, when you look at the health systems, there’s some really interesting things happening within a number of health systems.
[00:33:25] Bill Russell: [00:33:25] Yeah, absolutely. So, so what’s next for you?
[00:33:27] Bill Spooner: [00:33:27] We talk with Darren Dworken and from time to time,
[00:33:29][00:33:30] Bill Russell: [00:33:29] Wow. Your, your broadband has gotten your, your broadband has gotten really slow. I see the red signal there and it’s really slowed down. Is that because the clouds are going over right now?
[00:33:39]Bill Spooner: [00:33:39] I think that’s it. I think that’s it. I think maybe I can’t answer the phone or something. I was ready a period of time that when the phone rang, my, my internet would cut out. What’s next for me. I’m continuing, we went to there’s two things with CHIME and continued to, to, to be involved with a local health system to some extent and from time to time [00:34:00] doing projects through a consulting company About the time that I retired from Sharp, our longtime friend Ivo Nelson had this idea to bring some semi-retired CIO’s together.
[00:34:12] And we, we worked together for a couple of years until Ivo decided he really wanted to retire. So he found us a new home with a group out of Pennsylvania Hunsinger management group. And so instead of being next wave advisors, we are now Hunsinger advisors. And from time to time projects pop up, they’re always [00:34:30] interesting.
[00:34:30] One of the nice things about being retired is that if things interest you, jump into them. And if they don’t, you just shy away.
[00:34:39] Bill Russell: [00:34:39] Yep. So is that your property we’re looking at in the background?
[00:34:42]Bill Spooner: [00:34:42] That’s a picture I took go last, fall off my back deck. Yes.
[00:34:48] Bill Russell: [00:34:48] Man. That’s fantastic.
[00:34:49] Bill Spooner: [00:34:49] My property line is the second. You see the second line fence hedgerow up there. My property line is up there.
[00:34:56] Bill Russell: [00:34:56] So do you actually have to cut that grass?
[00:34:58]Bill Spooner: [00:34:58] There is a local [00:35:00] hobby farmer who cuts, the hay, and takes it off twice a year.
[00:35:06] The next thing for me is to get back on the road and do some traveling. I really miss having a trip of two abroad every year.
[00:35:13] Bill Russell: [00:35:13] So will I see you in San Diego
[00:35:16]Bill Spooner: [00:35:16] I believe so. My plans are now that I will get to San Diego to visit through the industry, friends happened to happen a great opportunity to see San Diego friends.
[00:35:30] [00:35:30] Bill Russell: [00:35:30] Yeah. Yeah. I hope to see you down there at the CHIME fall forum. I think that’ll be a wonderful to get back and get in front of everybody again. It’s been over a year since we’ve all been together
[00:35:41] Bill Spooner: [00:35:41] The virtual forums are. interesting, but they’re nothing like face to face. I think we’ve all got, to get through and see how comfortable we are with travel. Do I want to sit in a group of people, not knowing if they’re all vaccinated or not, et cetera, but I think by the fall we’ll have it [00:36:00] worked out. I’m optimistic about it.
[00:36:03] Bill Russell: [00:36:03] Yeah, absolutely. Well, I’m sorry for the delayed reaction and hearing things. It’s been a little tough, but hopefully our conversation will get up to DC and they’ll start funding some, connectivity to your part of the country.
[00:36:18] Yeah. Please tell them to send lots of money. We can use it.
[00:36:23]Bill Spooner: [00:36:23] Thanks for coming on the show. Appreciate it.
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