December 16, 2020

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December 16, 2020: It’s clear that social determinants impact health. Mikelle Moore of Intermountain Healthcare and Bill Crim of United Way of Salt Lake share details of their groundbreaking all-in-one care management digital platform. What leads to health disparities in our communities? How do we address these issues so that we can help reduce healthcare spend and improve health outcomes? There isn’t a textbook solution but the principle is the idea of co-designing with communities. Bringing the voice of affected populations to the table to hear their experience, to understand their challenges and to co-design the solution with them. What are some of the challenges that come with scaling a program like this up? And how do you measure the success from a health systems metric standpoint? 

Key Points:

  • An all-in-one care management digital platform used by community health workers to connect people’s social needs, health needs, mental health needs and substance use needs [00:05:35] 
  • Social determinants of health and social determinants of educational achievement are very much related [00:08:30] 
  • Why does one zip code have a 10 year life expectancy difference to another?  [00:10:30] 
  • The first scaling problem is around data interoperability. The second is the challenge of human behavior in a de-centralized multi-sector system. [00:24:40] 
  • Utah 211
  • Intermountain Healthcare 
  • United Way of Salt Lake

Scaling Social Determinants work with Intermountain and the United Way

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Scaling Social Determinants work with Intermountain and the United Way

Episode 342: Transcript – December 16, 2020

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

[00:00:00] Bill Russell: [00:00:00] Welcome to This Week in Health IT influence where we discuss the influence of technology on health with the people who are making it happen. Today we have a great conversation around the social determinants of health and really improving the health of our communities by addressing the social determinants of health.

[00:00:21] And there’s a really neat partnership between Intermountain and a lot of organizations specifically, we’re talking with the United Way, who has, who has partnered with, [00:00:30] Intermountain on that. And they talk about scaling that program up and the things, the challenges and the, the waste they’re going about addressing it. Great conversation, great topic. I hope you enjoy it. 

[00:00:41] My name is Bill Russell, former healthcare CIO, CIO, coach consultant, and creator of this week in health IT. A set of podcast videos and collaboration events dedicated to developing the next generation of health leaders. As we get to the end of the year I really want to call out our sponsors who have partnered with us on our mission to develop the next generation of [00:01:00] health leaders. Not only Sirius Healthcare who has partnered really strongly with us, for this year, but also our channel sponsors who we couldn’t do this without. VMware, StarBridge Advisors, Galen Healthcare, Sirius Healthcare, Pro Talent Advisors, HealthNXT, McAfee and Hill-Rom. We really appreciate your support. It gives us the ability to do what we do. So we have over the last two weeks, just want to make you aware of this, over the last two weeks of the year, we’re not going to be doing our normal programming, we’re going to do a [00:01:30] best of, so we’re going to do a, really a recap of the news by covering the 10 best stories, top 10 stories that we did this year. so that’s going to air next Tuesday. And then we’re going to do a top 10 from the COVID series. If you remember, we did daily shows for about three months where we talked to health systems about what they were doing around, the pandemic preparedness and addressing the pandemic as it was surging.

[00:01:56] And we took a ton of those stories and we put them into a single [00:02:00] episode. And then finally, we’re going to do our, very traditional, top 10 countdown of the most listened to podcast for this year. And we’re going to do a social media set of posts, top 10 countdown. We’re also going to do an episode that you’re going to be able to download on the podcast channel and listen to as well as well as on YouTube for that matter. don’t forget. We have the clip notes referral program. hopefully you’re getting clip notes. It’s a way to get an email 24 hours. After each episode, it’ll have a [00:02:30] summary bullet points and a one to four video clips, great way to stay current great way for your staff to stay current.

[00:02:36] We highly recommend it. And right now you can participate in our referral program. And potentially get some prizes, work from home kit. if you get 10 referrals, you get a mole skin, a black moleskin notebook, that I use all the time. And, If you actually get the most referrals, you get a chance to come on the show and discuss the news This week in health IT news day show you. [00:03:00] And I will sit across from each other on a zoom call and we’ll talk about the news. So a lot of exciting things going on as we approach the end of the year. So, without any further ado, let’s talk about this great topic. 

[00:03:14] All right. Today we have Mikelle Moore, the SVP and Chief Community Health Officer at Intermountain and Bill Crim the President and CEO of United Way of Salt Lake.

[00:03:25] I would say good morning, but it’s afternoon for you guys isn’t it. [00:03:30] well, welcome to the show.  I’m really looking forward to this conversation. We’re gonna, we’re gonna cover a fair amount of ground. We, it’s interesting. I was introduced to this work probably two years ago, CEO for Intermountain Mark Harrison came to the JP Morgan conference. I think he was really new in the role. And he, he talked about addressing social determinants. So you talked about partnerships you guys were doing in that market. And at that [00:04:00] point where I reported on this, I’ve talked about it on the show. I said, we’re going to keep an eye on this.

[00:04:04] This is really exciting work. So I’m really, I’m really excited to, to come back to it. So, Mikelle I guess I’ll start with you give us a little history of the work that you’re doing in partnership and in the communities and specifically around social determinants at Intermountain. 

[00:04:21] Mikelle Moore: [00:04:21] Well, thanks Bill. And, and you’re right. So back in fall of 2017, Mark Harrison, our CEO was, [00:04:30] on a plane bound for Chicago and he stumbled into Mike Levitt, former health and human services. Secretary, former governor here in Utah. And they had a conversation about the social determinants of health and said, what, if we were to do something to really demonstrate how the social determinants are impacting health and by addressing them can reduce healthcare spend, but also improve health outcomes.

[00:04:52] And out of that, we can see the Alliance for the determinants of health. We call it, that pilot’s been in [00:05:00] operation for about two and a half years now in, two counties in Utah. And the idea was this, that if we could organize around all of the services that people might need, that are getting in the way of them really activating improvements in their health and coordinate services for the individual and their family. And come to understand some of those underlying contributing factors, we could [00:05:30] probably make a difference. And so that’s what we’ve been doing. We have a digital platform for community health workers to use, to connect people from, their social needs. Their health needs, their mental health and substance use needs all in one.

[00:05:46] Kind of care management platform and allow that communication to occur to ensure that we get people, the services that we need. And it appears that we’re making an impact on their use of the [00:06:00] emergency department, helping to solve problems that fall between the gaps of one program or another. That might be a part of our social services agencies. And we’re learning a lot to help us scale this more broadly. In our state, but hopefully across the country as well. 

[00:06:17] Bill Russell: [00:06:17] Yeah, that, I mean, that’s, that’s some really exciting work and you guys, it feels to me like, there’s, there’s a lot of leadership going on here just in this space. There’s, there’s so many things to address Bill. I want to, I want to come to you. [00:06:30] Mikelle gave me so many things to follow up on my mind spinning here. I’m sorry about that. but bill, I wanted to come to you and, and, and let’s talk about the mission of the United Way and how it fits into this partnership that you’re you’re doing right now with Intermountain and others.

[00:06:46] Bill Crim: [00:06:46] Yeah. Yeah. Thank you. Our United way is, is really focused on, on two things. the first is, is we connect people in Utah to the very resources that Mikelle just described that they need. So [00:07:00] through the two, one, one. Infrastructure, which is a nationwide, use of the phone number two, one, one to connect people to resources.

[00:07:10] We operate that, in partnership with others in our state. And so as they were standing up the Alliance for the determinants of health, it became clear that being able to efficiently connect people to those resources, knowing. What those resources are having a database of the 10,000 different [00:07:30] resources in Utah that people might access, that’s important to this process.

[00:07:35] The other thing that has become clear over time is that it’s not simply a technical challenge of passing information from a healthcare provider to a social service provider. Right. There is a human challenge, to help that transfer of information result in a better outcome for, for the patient. And so, we’ve been involved in that process, doing [00:08:00] something we call a coordination center, which is coordinating between the providers and the community-based organizations to make sure people get where they need to go. 

[00:08:08] The second thing, and maybe the larger, challenge is, related to our mission to build partnerships that solve problems at scale. So for the last 10 years, we’ve been focused on transforming the educational environment for Utah kids. The [00:08:30] health environment is something that’s very much related to that much as there are social determinants of health. There are social determinants of educational achievement, and they’re very much related.

[00:08:42] And so we’ve been focused on that for 10 years, building partnerships across sectors with health systems and businesses and community organizations and governments and schools, to try to make sure that the education environment produces the best possible [00:09:00] result for every child. And this work fits very nicely into that. It’s an extension of the work that we’ve been doing to bring people together, figure out what the objectives of, of collaborative work are and then to work on those, in a unified aligned data-driven way. 

[00:09:21] Bill Russell: [00:09:21] Yeah. it’s, it’s amazing how many touch points there are. We’d love to think that it’s just a matter of getting the information [00:09:30] around, but it really is, inserting the right people, the right partnerships. I mean, it’s. This partnership brings together an awful lot of organizations. It’s not just the United Way and Intermountain, is it? 

[00:09:42] Bill Crim: [00:09:42] No, no, not at all. In fact, it’s important to, to know of Intermountain’s catalytic leadership role, and their embrace of the idea that we have to work collectively. That the systems that we’re trying to align and [00:10:00] integrate really are operated by many different organizations and  they, and we have invited all of those systems and organizations to the table so that we can, co-create a solution that works for everybody.

[00:10:13] Bill Russell: [00:10:13] That’s fantastic. We’ve talked a lot about how health inequities on the show. Mark Robes, the former CIO for Intermountain talked about the different zip codes and the disparities. Dr. Klasko was on talking about the same thing in Philadelphia. He was talking about the [00:10:30] mortality rates. Someone born in this hospital will live almost eight to 10 years longer than somebody who’s born in this zip code. Right down the street and Philadelphia. How do those inequities arise and what leads to the health disparities in our communities? Mikelle? 

[00:10:47] Mikelle Moore: [00:10:47] It’s, it’s interesting. This is exactly what prompted us to look at this Bill. And, we first in our communities, it’s about a 10 year life expectancy difference between a West side community and an [00:11:00] East side community, if you will. And for a long time, I think Intermountain thought the key to solving this was to create access to healthcare. Right? We did a lot of work to ensure that our financial assistance policies are understood by the safety net providers in that community. We put clinics in those areas. We did a lot of things to ensure health access. That isn’t the key. It’s gotta be deeper. Looking at the conditions in which people are living, the safety that they’re [00:11:30] experiencing, their opportunity for education. And, Bill knows this, I think he’s way ahead of us, because of his work in education, but understanding the health, all of those things are different geographically.

[00:11:45] Our poverty rates vary, and are geographically clustered. Educational attainment, income, et cetera, and it’s correlated with race often. And so we’ve really [00:12:00] begun to think about. How does  this Alliance that I speak of our work operates at multiple levels. We have to ensure that the individual where we’re meeting and getting to know today has the help that they need. But then we’re also looking at how do we contribute to the way our communities are designed, built, and managed to influence those other outcomes that are determinants of better health. And then how do we redesign those systems if there are just [00:12:30] not working. And, I think we’re finding that there’s more system work to do here, far more than we thought.

[00:12:38] Bill Russell: [00:12:38] Yeah. So it has the, as the, I mean, you guys are on the ground and you’re watching this. Has the pandemic. Impacted these communities more severely than others. Are we seeing that kind of disparity as well? 

[00:12:50] Mikelle Moore: [00:12:50] We are. And unfortunately it’s playing out over a long period of time. At the beginning of the pandemic, we thought that [00:13:00] because essential workers were staying in the workforce, others worked from home, they were at greater risk. And that seemed to disproportionately effect toward minorities and vulnerable populations. But that’s continued even as we’ve resolved, having personal protective equipment, having. Safe practices in employment settings, the disparities both in the way people are contracting COVID and then [00:13:30] whether they live or die from it does seem to vary by income, by race and by geography.

[00:13:37] And it’s complex. So one we’re finding that people who, feel vulnerable or disadvantaged by the healthcare system are less likely to come for care sooner. They wait longer. So they’re sicker. When they come in for care, they’re also more fearful and they have language barriers, cultural [00:14:00] barriers that make it more difficult for them to understand the treatment options that are available. Many of them are experimental. They require consent, a lengthy education and understanding of that treatment. And so as the pandemic has played out. We’ve had to shift and be responsive to that. At first it was making sure we were making testing available and easy and perceived as safe in, in those communities.

[00:14:29] Then it [00:14:30] became having community health workers explain the research protocols and the experimental treatments that were available in their language in a culturally appropriate way, in a safe way. Now it’s, really putting pulse-oximeters in the hands of the community health workers and teaching people the importance of getting care soon and home to call and having a culturally appropriate connection to make that first call. So it’s evolving [00:15:00] because the disparities are real. And I think they are giving us great insight into the disparities that exist in lots of health conditions. 

[00:15:07] Bill Russell: [00:15:07] This is it. I’m listening to you talk and this is a gnarly problem. I mean, you keep talking about culturally appropriate care and culturally appropriate, those kinds of things, just bringing the right people in the right setting together and Bill, I want, I want to come back to you and how do you, how do you organize that? How do you bring that together? [00:15:30] I mean, that’s, it’s one thing to say, Hey, we’re going to get the volunteers that really have a heart for this and the organizations that can do this, but then you have to match the right people into the right setting. It’s not just  throw people at it. It’s appropriately selecting the right people and putting them in the right place.

[00:15:51] Bill Crim: [00:15:51] Yeah, I think it is a gnarly problem. And there isn’t a textbook solution to it. There’s no, there’s no playbook [00:16:00] for this because it’s so contextual. It’s so relationship based. But I think that the principle that that one has to use is the idea of co-designing with communities, bringing the voice of affected populations to the table, to hear their experience, to understand their challenges. And to co-design the solution with them. And I think if you start with the assumption that [00:16:30] we think we know those of us who are in professional roles, you think we know a lot, but unless we have lived the challenges that people of color in low income communities, are living, then we are likely missing some important information. And so trying to co-design a system together. With them as is I think the starting point for dealing with that complexity. 

[00:16:53] Bill Russell: [00:16:53] So help me understand what that looks like. So a co-designing session is that, is that going out [00:17:00] into the community and doing like town halls? Is it, is it surveys? Is it one-on-one? Is it bringing people together in a design session? What does it look like? 

[00:17:10] Bill Crim: [00:17:10] It’s all of the above and multiplied over and over again. I think so there are trusted organizations that. That work in these communities. there are people, community health workers, Mikelle mentioned, community health workers are by definition, connected and close to the community.

[00:17:29] They’re not, [00:17:30] they’re not, white, 53 year old guys that, that go in their car to a neighborhood and try to figure stuff out. Thy are folks from the neighborhood who are trained to beat me on the health workers and to connect people that they know, there are networks of informal organizations. There are great community-based organizations that are, are doing daily work with these populations. So that’s one piece of it. [00:18:00] listening to people through two, one, one is another piece. We collect data every day through, calls and interactions with folks online, who are, who need help. And if we stepped past the initial sharing of information to understand more about it, About the lives and experience of those folks. That’s a piece of this. I think then it’s also, we invest resources in building the capability and identifying, the informal leaders in [00:18:30] communities and bringing them to the table. So at some point it is about co-designing with them. It’s about having people at the decision-making table, shoulder to shoulder with the. The executives of a health system and the CEO of a nonprofit and, and the CEO of a business, trying to do that together. And I want to emphasize that last point that co-designing across sectors is super important. I think our. Our country, [00:19:00] probably certainly our in our community, there’s a tendency historically to design in silos. Government programs get designed in silos and everybody kind of works in their own sphere and there’s nothing mal intended about that, but we don’t get the best thinking unless we put everybody in the same room over a long period of time working together. 

[00:19:23] Bill Russell: [00:19:23] Yeah. The further you are away from the problem, it’s, it’s hard to it’s hard to really [00:19:30] understand  how it’s impacting. And one of the things we have always looked at in health healthcare, we want to keep people out of the ER, but you know, if we don’t know that they don’t have heat, if we don’t know that they don’t have. the right living environment and those kinds of things. we’re were treating a, a symptom, but we’re not addressing the problem. And that’s always, always been the challenge. Mikelle, you mentioned the technology and I have to talk about the technology. [00:20:00] So coordinating the activities, coordinating the information, the information flow, is, is this something that you guys just give the community, community workers access to? And, is it an Intermountain program that used that you guys support and maintain for the larger community? 

[00:20:21] Mikelle Moore: [00:20:21] So, I’ll first provide a little bit of context that, ties to what Bill just said. When we, when we define an [00:20:30] aspiration for trying to improve health in this way, we listened to what gets in the way of sectors working together. And one of the first things we heard listening to her process list, we need a way to communicate with one another. We have this great resource in 211 where each of our services are listed. If you will. There’s a great directory. People know those resources exist, but we don’t have a way to know that when we [00:21:00] refer Bill to the food bank to get some food for the week and we’re trying to coordinate some job retraining. We don’t know if those issues get solved. We only stay in our silo. We asked for something we were refer something, and then we continue to follow the issue where managing. 

[00:21:18] And so, what our colleagues asked us from other sectors was give us a way to communicate with one another that also protects the privacy of the person that we’re serving, because [00:21:30] if we ever violate the privacy of the individual, we’re trying to help, then we’re not, we’re tech, we’re cut off from our opportunity to help. So we partnered with Unite Us to bring a platform to our communities. They have a lot of experience doing this and it is essentially a network that buildss on the knowledge that exists in the 211 directory resource, but then, puts each of the [00:22:00] service providers. On onboard that network so that they can communicate with others in the network. And then there’s a consent process for the individual that we’re looking to serve. they have to consent to have their information shared and then community health workers are using that platform to connect the others involved in caring, coordinating services.

[00:22:21] And it allows us to do a couple of things. One, we get to coordinate for that individual. We also get to understand. And our network. How [00:22:30] often do we have people aligned with the work that are needed to solve the problems we’ve identified? And when do we have to find someone that we’re not already working with closely?

[00:22:41] And then we can actually over time measure the performance of that network, and making that leap in healthcare to thinking about how we manage a network of still nursing facilities and. Specialists and primary care physicians and hospitals that are all involved in the continuum of care. We’re now [00:23:00] beginning to manage a network. If you will, of cross sector partners in serving a community. And that gives us different ways to think about how we redesign that network to better meet the needs of our time. 

[00:23:13] Bill Russell: [00:23:13] Well, I want to come back to you, shortly and I want to talk about the goals and the partnership from a metrics stamp from a health systems metric standpoint. What you’re looking at to say this is successful. Bill, I want to talk to you a little bit about scale though. [00:23:30] First. And, one of the greatest, challenges that we have is scaling out these really good programs. We might be able to do them in a single community and do them effectively. But you guys are attempting to do this pretty much statewide, which is, which is pretty exciting because if you’re able to do it statewide, there’s no reason why you couldn’t at least do it across all of it or mountains, service area, which will take you into a couple of other States. What are some of the challenges you face [00:24:00] as you scale this up? 

[00:24:02] Bill Crim: [00:24:02] Well, I think they fall into two categories. There’s the technical challenge of just getting everybody to everybody’s data systems to talk to each other. So, one thing that’s important to mention is that Intermountain has started this platform and, or is using this platform in this initial process. But other health systems have other ways of managing social [00:24:30] determinants, like kind of work like this, other, yeah. Other systems use other technologies. So really the problem be the first scaling problem is about data interoperability. I think it’s does my system talk to your system and does the data we’re putting into it exchange, freely and securely across systems. 

[00:24:53] So from a patient standpoint it doesn’t matter exactly where you start. you’re getting the same kind of service [00:25:00] and from a, a community-based organization standpoint, you’re not trying to populate 10 different systems with the same information. And so that’s, it’s a technical challenge on the one side. I think the, the more complicated, and that’s hard enough getting everybody to, to work out the data tech part of this. It was hard. And I think the larger scaling challenges, the human behavior challenge in a [00:25:30] de-centralized multi-sector system. So, the number of organizations in the Utah, two one, one database exceeds 2,500.

[00:25:42] Those are for the most part independent organizations that have to voluntarily agree to work in a new way to make that side of things work. And then there are a number of health systems that have to voluntarily agree and people have to be trained in new workflows. People have to buy [00:26:00] in and want to do it. People have to then adapt to their own processes. And all of that is kind of a human in a decentralized world where there is no single CEO to say we have a new process today, here’s your training. Let’s get it going. In a decentralized world that is a person by person, organization by organization, kind of conversation, to get everybody on the same page, rowing in the same direction.

[00:26:27] Bill Russell: [00:26:27] Mikelle, [00:26:30] coming back to that question. What, and actually I want to talk about this first from a, from a health system perspective. What kind of metrics are you looking at from the health system? And then I want to, I want to talk about from the program. What, what kind of goals and objectives do you think are, are, are, what are the targets for the entire program? So let’s start with the health system. What is Intermountain looking at to say. Hey, this has been, this is [00:27:00] making an impact? 

[00:27:02] Mikelle Moore: [00:27:02] Well, when we thought about the why for doing this, we knew we wanted to improve overall health outcomes and reduce total cost, and yet measuring health outcomes and total cost over a time period, that would be beneficial for communicating results and making decisions is really challenging. And so we discussed, feel that our metrics down to really focusing on two process metrics and one outcome [00:27:30] metric for the duration of our timeframe. So we’re focused on how many key partners do we get aligned successfully on the platform? So engaged in the network. Then how well do we adopt a change in workflow in the clinical setting?

[00:27:48] Where, to what degree do we adapt as screening, mechanism for assessing social needs and then change workflows. So we’re connecting people to resources and then [00:28:00] our outcome metric is to what degree do we impact avoidable emergency department visits. For this population compared to the population, that’s not a part of program because we’re only doing this in a couple of geographic areas. We have a built in, experiment design that we can use to see if we’re making a greater impact in this population versus the other. And, interestingly, we have found it far easier to get community [00:28:30] partners engaged in the network. Then to change our own work processes.

[00:28:34] So we’re now catching up on that. I know you laugh. We thought it would be the case, but we had no idea how true it would be. but we’re now gaining traction pretty equally in both, I would say, but it, it took some time and it was slower to come internally than externally. And we are seeing a decrease in emergency department use they will tell you COVID is clouding that data quite a bit because we know emergency [00:29:00] department use. Significantly for a period of time there. And so we’re trying to work out the noise of the pandemic in the data, but it does appear like we’re having an impact, proportionally in this population.

[00:29:13] Bill Russell: [00:29:13] Yeah. well, good luck, taking that noise out of the data. That’s a pretty significant impact to the, to the data. So it will be interesting to see where that goes. I do want to ask about funding a little bit because, I feel like. [00:29:30] It’s a gnarly, challenging problem. A lot of health systems have mission driven focus, and they want to do these kinds of things for their communities.

[00:29:38] But at the end of the day, some of them just don’t have the funds to do it. And when you’re talking about social determinants, where does the funding come from? Is it as a government? Is it health systems? Is it, I mean, where where’s, what’s the, what’s the source of, funding for this type kind of program.

[00:29:55] Mikelle Moore: [00:29:55] So I see, at least two key sources of funding that are [00:30:00] important for this to be successful. I think one and, and most importantly, if we are shifting to value based care, then it becomes the prudent thing to do, to think about how to make these investments, because it will be better for people that are for total costs if we do so.

[00:30:19] And in Utah, we do have a managed Medicaid model. So we have accountable care organizations that. are at least theoretically [00:30:30] already at risk for managing the total cost of care for Medicaid beneficiaries. So, that’s one ingredient, but second, there are a lot of things that are vague in, current regulations around what you can pay for it.

[00:30:45] As a part of your Medicaid offering you services. And, similarly there’s lots of other rules around housing and, and other resources. And so inner mountain did make a charitable [00:31:00] contribution at the beginning of this Alliance demonstration. To, a fiscal mediary who’s really managing that money and ensuring that it’s utilized by the Alliance in ways that fill those gaps.

[00:31:13] So funding community, health workers, funding, housing voucher, application fees, or driver’s license fees. other types of assistance that are in the white space. They’re not covered by any existing program, [00:31:30] but the objective is that we’re. Through the demonstration. Showing our a Medicaid plan is whether it, as well as other VA Medicaid plans that path for making these types of investments.

[00:31:43] Now I think it’ll need to also be supported by, the development of technology that can support and statewide level and some other things. For which there are some federal and other resources we could tap into. So we’re, we’re studying that now. 

[00:31:58] Bill Russell: [00:31:58] So I’m going to give, [00:32:00] I want to throw out a closing question. I’d love for both of you to answer, fast forward a year. A year from now looking back and we’re having a conversation, another conversation. What, what would be just a phenomenal outcome from your perspective? Bill, I’ll start with you. 

[00:32:19] Bill Crim: [00:32:19] I think next year, if we had a built-out single system that any provider couldn’t plug [00:32:30] into with an open APR so that we’ve got data crossing systems. And if we had a user interface that was available to patients so that they have a stake in this. I would say, and all there’s a lot that goes on, goes into making those two things happen and, and then other things that would have to happen as well. But if we have those two things in a year, I think that’d be miraculous. I don’t know if it’s possible to do it anyway, but that’s, [00:33:00] that’s awesome. On the horizon, this partnership hasrallied around the idea of creating a single statewide system that is interoperable regardless of the home health care. organization’s data system and a user interface for individuals to directly, sort of self-serve. 

[00:33:22] Bill Russell: [00:33:22] You know what Bill, if you had said that, let’s say a year ago, I would say. that is a long shot, [00:33:30] but after this year we’ve done so many things at such an amazing at what, what some people are referring to the COVID speed. I mean, we’ve just done things so rapidly that we’ve never done before. So. And it’s, it’s a very real possibility  with the right focus and the right people aligned. So it’s pretty exciting. Mikelle, you get the last word. 

[00:33:53] Mikelle Moore: [00:33:53] I would just add that we also, in a year, I hope we have data that tells us that this does make an [00:34:00] impact on the cost of care. And on quality of life for people that we’re helping. I think you’re right though, that COVID has accelerated our understanding of the need for this.

[00:34:12] And so maybe that proof point is less relevant today than it would have been than we thought a year ago. But I think it still matters and it’d be important for us to contribute that, to accelerate what bill described. 

[00:34:25] Bill Russell: [00:34:25] Absolutely. I want to thank to you for, not only [00:34:30] coming on the show, but I want to appreciate it. I really appreciate the work that you’re doing. And, I, I hope to get you on the show next year and remind you of what we said and see, see how much progress we’ve made. This is exciting stuff. So I look forward to catching up with you. 

[00:34:44] Bill Crim: [00:34:44] That would be great. 

[00:34:46] Mikelle Moore: [00:34:46] Thank you, Bill.

[00:34:48] Bill Russell: [00:34:48] What a great conversation. That’s all for this week. Don’t forget to sign up for clip notes. it’s a great way to support the show. It’s also a great way for you to stay current. if you’re not familiar, cliff notes is an email that we send [00:35:00] out, immediately following the shows actually 24 hours after the show airs. And it’ll have a summary of the show bullet points, key moments from the show and also one to four video clips that you can just watch. Great way to stay current, to know who was on the show and what was said. Special thanks to our sponsors, VMware, starbridge Advisors, Galen Healthcare, Health Lyrics, Sirius Healthcare, Pro Talent Advisors, healthNXT, McAfee, and Hill-Rom digital, our newest sponsor for choosing to invest in developing the next [00:35:30] generation of health leaders.

[00:35:31] This show is a production of this week in health IT. For more great content you can check out our website this or the YouTube channel as well. We continue to modify that for you to make it a better resource for you. Please check back every week. When to check back, we publish three shows a week. We have the news day episode on Tuesday. we usually have solution showcase every Wednesday and then an influencer show on Friday. but right now we don’t have any solution showcases. So we are doing multiple, We were dropping multiple, [00:36:00] influenced episodes. So a lot of content being dropped, between now and the end of the year.

[00:36:05] Hopefully you’ll like that. And also we have the end of the year episodes coming up and I’m looking forward to those. We have the best of the new stay show. So we take. 10 news stories that we covered this year and, give you some clips, give you an idea of what we went through this year. Obviously COVID was the big story, but a lot of other things happen this year in the world of felt it, we’re also doing a best of the, Of the COVID series [00:36:30] itself.

[00:36:30] If you remember, we did three months of daily episodes and we go back and we visit that time. And just some of the wisdom that was dropped by the leaders during that. And then of course we do our end of the year, top 10 countdown of the top 10, most listened to shows of the year. So you’re going to want to stay tuned for that.

[00:36:46] That’s we take a break the last two weeks of the year. And during that time we don’t stop dropping content. We just prepare it ahead of time and, make it available to you. So hopefully you’ll enjoy those. this year as well. thanks for [00:37:00] listening. That’s all for now.

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