Top 10 Most Listened to Podcasts on This Week in Health IT for 2019

EPISODE 174

[INTRODUCTION]

[0:00:04.1] BR: This Week in Health IT, our last episode of the year the Countdown of Our 10 Most Listened to a Podcast Interviews for 2019. That’s right. This week someone will walk away with the bragging rights for the coming year, the most listened to interview on This Week in Health IT for 2019. 

My name is Bill Russell CIO coach and creator of This Week in Health IT, a set of podcast videos and collaboration events designed to develop the next generation of health IT leaders. Special thanks to our channel sponsors VMware and Health Lyrics for choosing to invest in developing the next generation of health leaders. 

Reminder, we need your feedback, Thisweekhealth.com/survey. If you complete the survey, it only takes a couple minutes. Really helpful to me, to the staff as we try to figure out what is best going to serve the industry and to serve you as our listeners in the coming year. So that’s Thisweekhealth.com/survey. 

Before we get started, I wanted to thank everyone who appeared on the show. We had so many wonderful guests volunteer their time, their expertise, their experience, and their wisdom with us over the past year and it is really valued. I just want you to I know that I sincerely thank you for taking that time, spending it with me, giving me the opportunity to capture it on audio and video and then sharing it with the industry to hopefully propel the future health leaders forward as they are thinking about solutions for their communities. So thank you very much. 

So we’re going to get to the top 10. So a few notes about the tabulation process: time matters, right? So podcasts and YouTube videos are evergreen content, which means something that gets produced in January probably has more of an opportunity to be in the top 10 than something that got produced in July, August, September. So if you’re wondering, “Hey, how did I not make this list? There are some great episodes in the second half of the year, but the evergreen nature of this, I’ll give you one example, every time Dr. Klasko speaks, he gets a bump of about 40 downloads of the podcasts or of the of video on the YouTube channel. So there he’s speaking to 1000 people. They go out and search for him. About 40 of them find the site. They listen to the podcast, and so that’s naturally going to drive that up. So someone who who’s out in the public eye somebody who we interviewed before July, these are things that matter in the countdown. So just because this is the top 10 for this year, it’s a point in time snapshot. I’m sure if we did it at the end of February, it will be a different point in time. But I’m not taking away. These are 10 great podcasts. 

So let’s just get to it at number 10. Russ Branzell, the president CEO for CHIME, a professional organization within health IT. Russ has traveled the world literally has traveled the world over the past year or so, speaking to crowds in several countries and health systems and professionals. In this conversation, you know, we discuss some of the innovations that he’s found in his travels

[EXCERPT: RUZZ BRANZELL]

[0:03:42.1] RB: There is best practice out there in every area, especially this area of innovation or AI, or whatever you want to call it, across the globe. If we can just figure out how the leverage what’s already been done, never mind what’s being worked on, we could absolutely revolutionize healthcare. Even take a few years ago, a good example Drum Hospital in Singapore went from a materials manager department of hundreds of people to advanced robotics, delivering almost everything in a department of a few people. 

Well, that just sounds like, “Well, we just replaced people with robots.” No, it’s advanced AI-based. Their materials costs are way down. Their shelf-time is nearly perfect. Nurses and caregivers are saying that those are things they don’t even worry about anymore. So we augmented the care process and improved it by doing that when one of our members there. Probably some of the most interesting things we’ve seen, obviously, is what I would call proactive security and what we’ve discovered from an innovation perspective. And obviously there are countries like Israel that do this really, really well. Obviously they have to. They have a little bit different security requirement in their country than others. But when you talk to the security leaders that are there, where we talk about stuff well, we need to make sure we react to this or we’re monitoring really aggressively. Their answer is we need to catch 100% of everything coming in 100% of time and, if necessary, fight back 100% of time. Where I love some of the things that we’re seeing in places like the UK. Where they’re figuring out how to use advanced analytics to help manage patients in what I would call one of the few places in the world that are truly doing it holistically. They combined health and social care what we would call mental healthcare in such a way that the entire patient, the entire record, everything is being managed from a universal perspective. But not only that, they’re proactively looking forward on how to use it from a preventive perspective. Again, they’re using advanced analytics, technology, community engagement strategy, consumer strategies. You just don’t see that at least here domestically quite yet.

[END OF EXCERPT]

[0:05:36.1] BR: Yeah, that was a fun conversation with Russ, and I love what CHIME is doing internationally. Look forward to more of that in 2020. You’re going to hear me say that a lot, “I’m looking forward to more of that.” These are, again, 10 great podcasts. At number nine Carina Edwards. Carina Edwards is a rock star. If you don’t know where she was at Zynx, then she was at Imprivata, and instrumental in growing the the work at Imprivata. And this past year she took over as the CEO for a cool digital startup called Quil Health out of Philadelphia. And it’s a combination of some work from Independence Blue Cross out of Philly and Comcast NBC, and they brought her in. She is now the CEO, and we had a great discussion. 

In this clip, we talk about the foundation for digital, and that’s really data and data liquidity and the promise of digital, which is personalization. Have a listen.

[EXCERPT: CARINA EDWARDS]

[0:06:34.1] CE: Now, I think with 21st century Cures Act and TEFCA for legislation, we have the right as patients to make our data portable, right? And so that’s step one. And so now that I can get with Blue Button paving the way, I can bring my data into an app when I consent. I can also consent to share my information with others, and now you have a digital ecosystem with you and your support team, some people call them caregivers. Whatever name you want. They’re not that clinical professionals that care for you. These are your nieces or nephew, the friend that’s going to take you to the appointment. Now I can see, with those feeds, I can see schedules. I can see medications, I can see claims data. And from that, I can share with you a comprehensive recommendation of what to do next. Not just on the journey you’re on. So in the current pilot that we have now, we have some patients that are going in for a hip replacement. Great. Full stop. 

Now, you add to that, though their BMI’s 40 and they’re a smoker. So before we get them on the table, can we also get them to potentially change some behaviors in the next 7 to 8 weeks that will make them better for that that encounter and get to the better outcome. And I think finally, our incentives are aligned. Because now, with value based bundles, right, the risk lies with making sure that patient as well. If they get re-admitted then I hold the cost for that. So What can I do to drive adherence, education and really then get through this thing, journey together and get them to the healthiest version or themselves? Because it’s not about everybody needs to go climb a mountain. And so this has to be innately personal, right? 

When you think about the content, I had a friend who was going through his journey, so I said, “Please use Quil, give it a shot, give me a ton of feedback.” And his best feedback was, “Stop showing me 80-year-old women in walkers. I’m going to be back on the golf course soon!” And I said, “Fair point.” So I turned to the team and I said, “What can we do for customization and personalization?” And so within a month we’ve now tagged all of the content and we’ve actually done a demographic tag and so literally I can present to you, based on your goals, what are you looking to achieve? Are you looking to play with your grandkids? Are you looking to run a 5 K? Are you looking to get back to a marathoner? There’s all — everyone has a place they want to start and where they want to go.

[END OF EXCERPT]

[0:09:15.1] BR: Wow, there were so many insights in this podcast, it was hard to pull just one clip. I would encourage you, as with all these, but this one, I would encourage you to dig it up and have a listen. A lot of great conversation at that on that podcast. 

So the coming in at number eight is one of the good guys within healthcare. Drex Deford and I sat down and discussed the announcement of Haven, which is the Amazon Berkshire Hathaway J. P. Morgan joint venture. Drex is a great guest. Similar to myself, he’s an independent consultant. So he travels around a lot, gets to talk to a lot of different people, interact with a lot of different health systems. So I tried to have him on a couple times a year and just try to catch up on different things. And a lot of times we talked about the news, things we’re sharing on our feeds and those kind of things. You know, I know that this episode got a majority of its listens because we talked about Haven. But as I was listening to it again in preparation for this show, I found a clip, which quite frankly, I thought was more interesting from that show on. We talked about an article that he shared on social media about how the EHR was having mixed results in rounding at different health systems and it had four reasons for that. And we just we went back and forth a little bit on it. So have a listen.

[EXCERPT: DEX DEFORD]

[0:10:47.1] DD: I thought the same thing when I read the article. I don’t know that any of those things surprised me. I think the real sort of take away in that is our inability in healthcare to yet create clinical standard work around the use of the electronic health record. So we’ve, you know, to sort of turn a phrase, we’ve kind of paved a cow path instead of sort of sort of saying, “We’re going to do everything a different way,” said, “Now that we’re using EHR, and that means we’re going to change the way we do morning rounds so that we can integrate EHR more effectively and not do work arounds.” That creates a whole group of risk in it of itself for patients and families and none of us really want that. 

But I think we’ve still sort of got this weird situation where we have clinicians and others who are unwilling to change and unlearn the habits that they already have about how they do morning rounds and other clinical prevision of care too. But in this instance particularly around morning rounds, they’re unwilling to sort of change their ways of doing it, to integrate the EHR more effectively. And then I think the other part of that is sometimes the EHR doesn’t work very well to be able to facilitate the work that they’re trying to do, too. So it’s really sort of two different pieces of this one is a management engineering effort to make sure that we’re using the EHR as much as we can in the workflow and that the work has been modified to adopt to the EHR, and the other one is changing the EHR doing the inframatics, the stuff that we need to do to make sure that the right date is available needs to be used in morning rounds.

[END OF EXCERPT]

[0:12:09.1] BR: There you have it, coming in at number eight, Drex Deford. As I said, one of the really good people within health IT. Regardless of what Wes says about him in the good news for Drex is that, Wes’ episode is below Drex’s. So, at least within the two of you you have bragging rights for the coming year. 

Following the Epic UGM meeting, I keep calling it a conference. It’s a user group meeting. Following Epic UGM, I caught up with Dr. David Butler to get his thoughts around the meeting. He was in his bell bottoms he was still hyped up on caffeine. And, you know, quite frankly, we caught him on the way to the airport. So he was sitting on the side of the road. You know, maybe next year we can catch up to him in person and not as frenzied a conversation. But, you know, again, I think he captured really well the the essence of the UGM meeting in this short clip. 

So coming in at number seven for 2019 Dr. David Butler, Principle and Chief Digital Officer for Helix Partners from Epic UGM.

[EXCERPT: DR. DAVID BUTLER]

[0:13:26.1] BR: And you know some of the patient-centered things that I’m picking up on are, you know, Epic’s Happy Together Unified patient centered view of MyChart. You had, MyChart estimates you had care everywhere patient initiated sharing of the record. Yeah, I’m just throwing out some of the things. Where there’s some other things they did that you heard that you were like, “Yeah, they’re really making movement around this around patient centered around helping physicians be more patient centered?”

[0:14:00.1] DB: Yeah, you know, I think you totally rattled off the big ones and those are a lot of sometimes I call Epicisms. Some of those words and so non-Epic clients might not know what that means or even patients that may be listening. So, yeah, putting the care into the patient’s hand is what it’s about, and that’s where it’s going to — It’s been about. And so where if you have three different records, like, for example, I moved over four states, me and my family for various jobs. I have about five different MyChart accounts. Now, one click, I can now see one patient portal and all my data. And if I go to a doctor somewhere and that doctor does not have [inaudible] it could be an urgent care I can always share everywhere. I could give them a code. They’ll log into a website, not a patient portal. They could log into a website put in that code because I’ve given them access to my notes or whatever they need if they need that. So I think that it what has been the biggest one of the bigger deals innovation that I’ve seen in over 10 years of dealing with Epic as far as on the patient side without much build or effort on the client side. 

[END OF EXCERPT]

[0:15:02.1] BR: All right, 2019 was a breakout year for This Week in Health IT And I’m going to take a couple moments within this show to share with you where we’ve been and where we’re going. You know, our mission is to develop the next generation of health leaders, and we do that by amplifying great thinking. And that’s why we do the interviews, why we do the podcast. And that’s why we’re going to do some collaboration events coming into 2020. 

You know, with that in mind, our goal was to get this, to amplify great thinking, to get this thinking in the hands of his many health IT professionals as possible, people on the front lines that could make a difference. And by our measures and by our goals, we exceeded every goal that we set for this year. We had 100,000 audio downloads of podcast we average in Q4, here’s a couple things we did. We averaged 2,700 downloads per week, 154 hours of watch time on YouTube and 10,000 page views on our website. 

We really revamped our website towards the second half of this year. Quite frankly, it was pretty lame in the beginning of the year and we’re going to continue to do that on. That’s one of the areas we’re going to use our sponsor money is to make that content more accessible to more people. We also had 200 new subscribers since July to our email services. We have a couple of those that we send out. So our accomplishments for this year we piloted a virtual summit. We had 100% NPS on that and I’m looking forward to rolling that out in 2020. 

We created guest profiles on the website, Thisweekhealth.com/guests. Easier way to navigate if you have a favorite person that you follow or are interested in, you go to that site all the pictures of their click on it and then underneath that, a lot of them have a profile. I’m a little behind, but a lot of them have a profile, and those that don’t have a profile, it will have the episodes that they appeared in. We launched a weekly news show and then we revamped it twice this year, the second, the most recent time we revamped it. What you said to me is, you wanted me to take the top 10 stories for the week. I’ll be shocked if there’s 10 stories every week, but there has been so far. So top 10 stories and tell you why it’s relevant to health IT and then circle back and go a little deeper on one or two those stories. 

So we started that new format, probably in November, and again, the feedback on it so far has been pretty good. We launch staff meeting, which is designed to help you get the conversation started on the right foot. We take a little longer clips from these interviews, and then we put some questions around it. So you could give this to nurses who want to talk about security or those kind of things. They download it, they watch it and it just has two questions to get the conversation started. And then we launched insights. Insights is really about personal development. So we’re taking shorter clips and we’re putting some context around it of how health IT professionals can apply some of the things that we talked about on the show to develop their career and to advance their work within the health system. 

All right, back to our countdown. Number six, this is a podcast, as I mentioned earlier that I expect to climb. I sat down with Nasser Nizami of Jefferson Health, CIO for Jefferson Health and Dr. Stephen Klasko, the CEO for Jefferson Health, on one of my trips to Philly. In fact, you know, two of our top tens from that trip are from that trip to Philadelphia. Karina Edwards with Quil Health and now this interview with with the people at Jefferson Health. And you know, as I said, every time Dr. Klasko speaks, we get a spike on the number of downloads on the podcast and video. So I imagine in no time this will probably surpass all the other podcasts just because he speaks an awful lot and because he’s very provocative. He makes statements that cause us to think and cause us to have conversations, which is why I really enjoyed this conversation. He’s challenging the age old truth that we hold onto and to a certain extent, hold us back. 

Here’s a clip that I think really demonstrates that.

[EXCERPT: NASSER NIZAMI & DR. STEPHEN KLASKO]

[0:19:49.1] SK: I’m old enough to remember when EMRs were just starting and you know, the Epics of the world, the Allscripts, the Cerner’s of the world will come to us and say, “We want you to help us develop this.” We’re fun. Our handwriting is fun. Same thing happened with Telehealth people are mailing it in and saying, “Oh, I just got [inaudible], Teladoc, MDLive to some person in Ohio and I could say, I’m doing Telehealth. We took a totally different approach and one of my mentors and actually our commencement speaker this year has been John Sculley, he said, “Stop talking about Telehealth,” he said. We don’t talk about Telebanking. We don’t get up in the morning, “I think I’m going to telebank.” It’s just a 90% of banking went from being in the bank to being at home. The same thing’s going to happen. So the question for you, Steve is, what technologies can use to have more and more and more things for the patient happen at home so they don’t have to see you? And that’s how we view things. We have 24/7 Telehealth virtual triage. 

Now, here’s the problem. Once you get to that, it’s going to become painfully obvious that if you’re a provider, you have to be a payer also. I’ll give you a real life example of virtual triage. Given our sophistication in Telehealth and IT, we’re now at the point where we get 60% of our patients non trauma, non ambulance out of our expensive, inefficient ED, and we have about half a million patients come to our ED. Problem is, I make an average of about $89 through urgent care, Telehealth or appointment next morning, an average of $1400 if somebody walks into my ED that the insurers are happy to pay. We have 32,000 employees now, Bill. 

So what we said is with our TPA partner, Edna, we said for 32,000 employees if you show up to our ED and you haven’t gone through JeffConnect virtual triage, $500 deductible. If you end up in our ED through JeffConnect, zero deductible, including zero deductible if you end up getting admitted. That’s really changed behavior. So there’s a great Upton Sinclair quote, “It’s hard to get somebody to do something when their salary depends upon them not doing it.” And we do so much of that healthcare. And I think it’s especially true when you talk about population health. You’re sitting here in Philadelphia with five academic medical centers, two in the top 25, us and Penn. Now we have the greatest discrepancy in life expectancy of any city in the country.

[0:22:33.1] BR: Based on based on zip code?

[0:22:34.1] SK: Based on zip code. So baby born today at Jefferson that goes to 19147, which is about, you know, 3/4 of a mile from here, we’ll lift to 2104. A baby born today that goes about three miles north of here, north Strawberry Mansion will not make it to 2090. That’s a year less than Iraq and Syria. So while we talk about meds and eds in Philladelphia, we failed, and the simple answer is that 80% of a person’s health, as much as we hate to admit it, has nothing to do with the doctor or the academic medical center or the research that I’m doing here at Jefferson. 

So that’s why that whole you know B2B to B2C model becomes so important. You know who the greatest percentage of users of JeffConnect our telehealth program are? Is this situation we have with the homeless, with the homeless shelter. Sister Mary is one of the largest. Why? Because if think about it, most of them don’t have cars. They’re housed in this great thing called Project Home. If they have cars, gas is expensive, but they have phones, you know, and they want their families to be healthy. So I think we just haven’t come close to pushing the envelope of getting away from I’m just going to get this company so I could say I’m doing stuff versus really believing you want to do it. 

[END OF EXCERPT]

[0:24:03.1] BR: Yeah, thanks to Nassir and Dr. Klasko for really a thought provoking conversation. I love the CEO-CIO dynamic on the show. It was a really good back and forth. If you get a chance to watch it the you know, the two of them talking about fire interoperability, telehealth and other things. It was good back and forth. I’d love to do more of those shows next year. So if you’re a CIO who wants to come on the show and you’re not sure whether I’ll have you on the show, get your CEO to sit down with us, CEO-CIO. 

I love that conversation because we can talk about the strategic application of technology within your health system. And we could also talk about specific projects that you have been successful at in your community in taking that forward. Already what I’m seeing on the end of your survey is that people want us to start to elevate some of those stories where people have been successful so that they can implement those things. 

All right, so our next one — that was number six our next one. So Fortune Magazine wrote and article this year, and everyone who’s in healthcare is aware of this article. It’s called Death by 1000 Clicks: Where the Electronic Health Record Went Wrong. And, you know, we talked a lot about this. As soon as I read this article, I knew I had to talk about it with a clinician, somebody who’s been in the trenches, somebody who’s implemented EHRs at multiple systems. And so I called my friend at Starbridge Advisors who do consulting work across the board. I knew they’d have somebody I could talk to, and they connected me with Nancy Beale. 

So this is the first time Nancy and I met was on this show, and she was a phenomenal guest. She’s a registered nurse, NYU, I think she was at Childrens in Ohio, at Children’s hospital in Ohio. So she had implemented a lot of EHRs, very familiar with the process, very familiar with the article and we just we just dove right into it. It was really good. So in this clip, I asked her, you know, what is something we could do to address the unintuitive — these are words straight out of the article — unintuitive, clumsy, and hard to navigate EHR? 

Have a listen to this clip from our number five most listened to podcasts for 2019.

[EXCERPT: NANCY BEALE]

[0:26:29.1] NB: I think there are three things really design, implementation, and optimization and what they do — What successful organizations that I have worked with do is really ensure that they have highly qualified clinicians engaged in the design process. And when I say highly qualified, what I mean by that is not just somebody who might be available who happens to have RN or MD after their name, but actually somebody who understands technology and has some level of experience and/or education with technology. So I really believe that clinical informatics is crucial in appropriate design. 

Likewise, those same clinicians are essential when it comes to implementation, implementation strategy, spotting where the problems are, identifying the folks who are really struggling, how do we solve those problems or identifying what could be really dangerous situations that are occurring, that otherwise you may not know because you have that clinical connection and then ultimately, optimization. You know, we — one of the things that really encourages me to be interested in pursuing how we measure technology adoption and putting some standardization around that is that we continue to develop all these really wonderful technologies and some are integrated and some are not. 

But we put some of these things out there and don’t always measure how they’re being used and if they are in fact being used as intended. And one of the challenges with that, of course, is if you have work arounds that are occurring, there could be downstream implications of that and in fact, even patient safety implications of that. So really optimization going back after the fact, making sure that what you implemented is actually working and if it’s not, how we make it better.

[END OF EXCERPT]

[0:28:24.1] BR: Yeah. I want to thank Nancy for coming on the show. We tried several times after this recording to get together, and have been unable to at this point, but I would love to have her back on the show to have further conversations. So we’ll see if we could make that happen. 

[BREAK]

[0:28:42.1] BR: We’ll get back to our show in just a minute. As you know, Health Catalyst is a new sponsor for our show and a company I’m really excited to talk about. In the digital age, cloud computing is an essential part of an effective healthcare and precision medicine strategy, and we’ve talked about it many times on the podcast. But healthcare organizations themselves are still facing huge challenges in migrating to the cloud. Currently only 8% of EHR data needed for precision medicine and population health is being effectively captured and used. That’s 8%. 

One of things I like about Health Catalyst is that they are committed to making healthcare more effective through freely sharing what they have learned over the years. They published a free ebook on How to Accelerate the Use of Data in the Delivery of Healthcare and Precision Medicine. You can get that ebook by visiting Thisweekhealth.com/healthcatalyst and, you know, this is a great opportunity to learn how a data platform brings healthcare organizations the benefits of a more flexible computing infrastructure in the cloud. 

I want to give special thanks to Health Catalyst for investing in our show, and more specifically for investing in developing the next generation of health leaders. 

Now, back to our show. 

[EPISODE CONTINUED]

[0:30:04.1] BR: Okay, we’re at number four. The fourth most most listen to podcasts for 2019 is a former CIO and someone who made the move just now in 2019. Actually, not too long ago now that I think about it. Dr. John Halamka is now the head of platforms for Mayo. And we sat down following the HIMSS Conference to talk about this patient centered interoperability, among other topics. Here’s a clip from that conversation.

[EXCERPT: DR. JOHN HALAMKA]

[0:30:35.1] JH: So I will take your theme of using natural language processing and machine learning to craft a less burdensome clinical experience to even tell you about a larger trend, which is machine learning not going to save us all, right? Got to be very careful about that. You know, I wouldn’t want to criticize any particular company’s marketing strategy, but the likelihood that Dr. Watson is going to read 1000 articles and treat you tomorrow with no human intervention isn’t happening in the next six quarters. 

What’s happening in the next six quarters is I can say, “Oh, I have studied a 1,000,000 patients like Bill and what I know is that I could improve Bill’s lifestyle If I make these two or three interventions and I offer these two or three incentives and that kind of thing the patients of the past informing the care of the patients in the future gets us closer and closer to a personalized medicine approach. We’re already deploying a dozen such projects at Beth Israel Deaconess. And it’s simple things like, “How do I schedule the OR? Who’s going to show up to the appointment? How long are you going to be in an inpatient setting and maybe we can schedule all the events in a Gantt chart and not randomness? Or how is it that I can figure out for the wellness care that is going to reduce your medical expenses and improve quality that I can put you through the right preventative rather than curative kinds of measures? All these sorts of things we’re doing with existent 11 petabytes of patient identified data hosted at Amazon Web Services, Google Cloud and other places under BAAs to figure out the possible, and it works.

[END OF EXCERPT]

[0:32:09.1] BR: You know, I’m pretty sure no one put on more miles last year than John in pursuit of innovation in healthcare. You know, I really am excited that Mayo he’s joined Mayo and no pressure, but I’m really expecting great things for them in 2020. You know, in our top 10 we have two acting CIOs. They’re both with new organizations in 2019. But they are two acting CIOs, which is fantastic. 

The next one is someone that I think is a really great thinker in the digital space and also gets the conversation going with with really provocative statements. Jonathan Manis says the CEO for CHRISTUS Health and we sat down to talk about the digital hurricane. He had brought this up maybe a year and half, two years ago, maybe three years ago now that I think about it — at a conference and it stuck with me. You know, I downloaded the the presentation that it came from. I’ve talked about it with several people, and I thought when John came on, I thought, “This is a great opportunity to talk about digital and specifically the digital hurricane and how how industries go through this change that digital brings upon them. 

So in this clip, John and I discuss the impact of digital on healthcare.

[EXCERPT: JOHN MANIS]

[0:33:38.1] BR: Where do you think we’re at today with healthcare in terms of this digital hurricane? 

[0:33:43.1] JM: Well, I think we’ve still we’re still on the outer bands and and we’re fighting it tooth and nail toe not get towards, you know, our digital destiny as it were. I think, you know, we are in many ways, a lot like other industries who just can’t seem to let go of our current model. We’ve got so much invested in terms of capital in facilities and brick and mortar buildings in an old operating model in an old clinical delivery model, and we don’t know how to let it go. We are we are doomed to failure if we can’t let go of the things that have made us successful for many years in order to be successful in the in this new environment and there’s no question in my mind that, you know, I think about the millennial generation’s that Gen Xers, the folks who are being born even today, they’re a very different breed of people. 

People want to know, “Why are we on the outer band of that hurricane?” It’s because we haven’t had to change and nowadays, in modern life, you know, there’s a different expectation for service, and people want to be served when there is an immediacy expectation. They want to be serviced when, where and, how they want to receive service is and and they frankly don’t care about the convenience of the supplier. It’s all about the convenience of the customer, and and we have been very slow is an industry to realize that.

[END OF EXCERPT]

[0:34:55.1] BR: There it is. That’s the number three most listened to Podcasts 2019 with Jonathan Manis the CIO for CHRISTUS Health. You know, realizing our digital destiny. I just — Those are the kind of phrases I just love. Realizing our digital destiny. It is our destiny. It is what’s going to happen in healthcare. It’s just a matter of when are we going to embrace it and how are we going going to get from where we’re at two to that point in our future. So we’re getting close. We only have two spots left. Before we get there I want to talk about 2020. I want to talk about where we’re going as This Week in Health IT is going in 2020. 

So this past year, we launched inside staff meeting. We piloted virtual summits. All of those are going to continue in 2020 and we’re going to expand those in 2020. Two main things, really three main things I want to talk about here. One. I want a partner more closely with health systems. If you have thoughts and ideas of how we could partner together as a health system and the show in terms of developing content and bringing content to your staff to help them to stay current and to develop so that they can serve the community and serve your health system better, I want to talk to you. 

So shoot me a note [email protected] and let’s have a conversation. I’d like to know how we could do that more effectively and how we can help you, because one of things I am aware of is, you know, budgets are going to get tighter, and the first thing that goes is travel. And the second thing that goes is training, and we cannot afford to not develop our people. And I want to help you to develop your people and to continue to move things forward within your house system. Keep them current and keep them exposed to some of the great work that’s going on within within the industry itself. So that’s the first thing I want a partner with Health Health systems. 

The second thing is that,  we are going to be — so there’s two things in terms of production. The first is, if you are thinking, “Hey, I want to do a podcast.” around the health I t in the delivery of healthcare. Then I’d like to talk to you because I think we can help. A lot of people are sitting back to go, “I’ve got a great idea. I want to launch a podcast. I don’t know if I could do it is often his bill does whatever you know, that’s really fine. What we’d like to do is we’d like to support you in that we offer production service’s we offered tutorials. We offer coaching. And we’ll even offer our platform to highlight and to host your shows on our website going forward. 

So if you’re thinking “I have an idea for a great podcast, I would like to develop content that will help to develop the next generation of health leaders.” in whatever area I’d love. You know, you know, work and you could focus in on a specific space within healthcare. That would be great. I’m going to continue doing the two shows, the news show and the interviews. And if you’re doing something that is a complimentary to what we’re doing that develops health leaders, I want to talk to you, [email protected] Let’s start a conversation and see where that goes. 

And then finally, I can’t be everywhere. There were a bunch of conferences I wanted to go to last year that I couldn’t go to. And, you know, one of my friends introduced me this concept of Ambassador. I know I’m not the first to do it. I know others have done it. But I would like to start training ambassadors. So if you’re going to conferences and think, “Hey, I could do an interview like this with a phone and with a with a mic.” That is true, you probably could do it. I’d like to talk to you about if you could be an ambassador for This Week Health events so that we can cover more of the shows that are out there. 

So again, those three things: partnering with health systems, hosting new podcasts and helping you get him off the ground, and then the Ambassador program, [email protected] So that’s it. You know, we made the show for healthcare by healthcare. So we’re healthcare leaders helping and supporting other healthcare leaders. 

Okay, we are now at number two, and you know, I’m fond of saying that buzz words in the hands of the wrong people remain buzzwords. But buzzwords in the hands of the right people, it’s magical. It’s exciting, you know, when the right people are working with the really cool technologies it, you know, it sparks your imagination. It makes you think of what’s possible, and it gives you hope of what’s going forward. And one of those people comes in at number two. It’s the VP of R&D for Epic, and that’s Seth Hain. And I’d love the conversation. We just went back and forth. He told me about all the things that they’re looking at and they’re doing. And then he got into really where it’s being applied. In this clip, we talked about how they’re helping even the smallest rural hospital and health system apply AI to the challenges they face.

[EXCERPT: SETH HAIN]

[0:40:34.1] SH: A couple come to mind. The first one is North Oaks, an organization down in Louisiana, and they’re actually one of the organizations — they’re a community hospital down there that has at this point adopted over 10 models from our machine learning my library. They saw a 40% reduction in codes outside of the ICU by implementing deterioration models, which really are a way, you know, if I’m thinking about from the patient perspective, I could be confident when I’m either, you know, maybe unfortunately, on the med-surge floor or a family member next to somebody that’s at the hospital. 

I can know that as those monitors at the bedside or collecting information, the system is running in real time analysis of that information along with my longitudinal chart to understand my risk of, say, a hospital acquired infections, deterioration in the context of North Oaks here, early onset of sepsis, and then alert individuals maybe say in the ICU, that I need some intervention somebody to come check on me. So North Oaks certainly stands out as one example.

[0:41:36.1] BR: Let’s stop on North Oaks real quick because that kind of surprised me that you started off with a community hospital in Louisiana. You know, you would think that the organizations using this are in, you know, in Seattle or LA or San Francisco or Chicago. But you’re saying that, you know, even the small hospitals have access and the benefit of utilizing these models. Is that because you’re packaging them up in a way that they could just implement them out of the box? 

[0:42:08.1] SH: Yeah, And that’s the key to those two approaches that I spoke of earlier. Right? The library enables organizations to quickly begin implementing and using those models in their existing work flows and the underlying platform provides them the options to do that cost effectively. It’s cloud based. So as they need resources to localize or retrain models to their particular populations, they can spin up those resource is in a public cloud, train those models and then implement them directly back into work flows without needing to bring all that infrastructure and house. So, yeah, our goal is really to help organizations of all sizes. I grew up in a small town outside of Lincoln, Nebraska, with the community hospital, right? Help organizations like the community I grew up in be able to implement machine learning for all patients.

[END OF EXCERPT]

[0:43:05.1] BR: Yeah, that was a great conversation, and one that makes me optimistic about the future of technology and healthcare. We’re here, we’re at number one. But first, let me count him down for you. Number 10 was Russ Branzell. Number nine, Karina Edwards. Number eight Drex Deford. Number seven, David Butler. Number six, Stephen Klasko and Nasser Nizami, with Jefferson Health. Number five, Nancy Beale talking about Death by 1000 Clicks. Number four, John Halamka. Number three, Jonathan Manis and I talking digital health. And number two was Seth Hain, the VF of R&D for Epic.

So have you figured it out, who is number one yet? Do you think you know who is the number one? It is a CIO. It’s an acting CIO. The most listened to podcasts for the year comes from the CIO of Providence, St. Joseph Elf and former Microsoft executive BJ More. BJ is one of those CEOs from outside the industry that is really challenging the status quo. He really makes no bones about it, and he’s unapologetic about its lack of healthcare experience. I love the conversation we had and, you know, I found a lot of this conversation to be really, extremely refreshing and thought provoking. 

Here’s a clip from our most listen to podcasts for 2019 with B. J. Moore, the CIO of Providence St. Joseph Health out of Washington.

[EXCERPT: BJ MOORE]

[0:44:24.1] BM: Well, first some background on what I did at Microsoft. So I was responsible for all of our commercial revenue systems. So a $70 billion business. And you asked earlier why I decided to leave Microsoft. One of the reasons is I’d completed our cloud journey. I was happy to say as of last October I had moved this $70 billion business to be 100% on the cloud, not a single asset on premise. And so it’s a play forward from what I expect to do at providence. I expect to do a similar thing. You know, we’ve got various data centers, all 4,000 of these applications are hosted on brand leveraging the cloud services. So the journey as I see it today, you know again, three weeks in, I need to learn more is really getting out of that data sum business, getting out of the business of hosting your own applications and that isn’t going just be taking these 4,000 applications we have and moving it to the cloud.

First thing it’s going to be to simplify this environments immediately. And so instead of moving 4,000 apps, maybe moving a thousand applications off premises and into the cloud. Yeah, it’s going to be using, you know, infrastructures and service, probably primarily the with shifting these applications to the cloud. On the data front we talked about that for data strategies now include big data and leveraging the platform as a service with the cloud offerings you have. You know, Amazon and Microsoft and the sound data spreadsheet along that and then adopting software as a service. And so we’ve selected Oracle Financials. They’re in the cloud as our ERP. And so, well in the case of ERP we’ll get away from on premises all together. Moved to a software as a service model. What will it look like to me? Is, I don’t know how long that journey takes two or three years, but um, you know, we’re either all infrastructure as a service, platform as a service, or software as a service. And this concept of pushing these applications on premises just goes away. 

My team looks at me like I’m crazy, but if I can move a $70 billion, nobody would accuse Microsoft of having a simplified business model. If I can do that already, I feel at least I’ve got the chops to do that.

[END OF EXCERPT]

[0:47:03.1] BR: That’s it for our top 10 for 2019. Going through this list gets me excited about where we’ve been. But what we’re going to be able to do in 2020. 2020 is going to be a great year in the application of technology in the delivery of care and health. Thanks again to all of our guests for 2019. I really appreciate your time, your dedication, your expertise, and sharing that with with the community so that we can advance health really across the globe. Your time really makes this show possible. 

Thank you for our sponsors. Your investment in developing the next generation of health leaders is greatly appreciated. And I look forward to what we could do in 2020. This show is a production of This Week in Health IT. For more great content, you can check out our website at Thisweekhealth.com or the YouTube channel. 

Thanks for listening!

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