It's Tuesday News and here are some of the stories we covered.
Bill Russell: 00:08 welcome to this week in health it news where we are looking as many stories as we can in 20 minutes or less, that will impact health. It, it's Tuesday news day and here's what we have on tap. Actually, it's Monday, it's Labor Day. I'm recording this and uh, I have grill duty, so I'm going to have to leave here in 20 to 25 minutes. I'm going to record this straight through. I'm going to go out and start cooking the brots and hotdogs for the, uh, friends who are coming over this afternoon. Uh, let's take a look at some of the news stories before I do that. So, uh, we're going to talk about UGM because it's news. You should know what's going on. We had two episodes, uh, with, uh, one with Dr. David Bensema by one with Dr. David Butler. Uh, a new guest with a Calyx partners and uh, uh, you're gonna wanna check those out.
Bill Russell: 00:51 This is going to be just a brief rundown of some of the things that went on there. Uh, let's see. We have a couple of of US security stories. That's never good. Hardly ever good. Now these aren't good. These are, but we're going to talk about some security stories that have come up, even an apple story that's not good, uh, that you're going to want to know about for your iPads, iPhones and whatnot. Um, we're going to talk about consumers. I'm talking about medical records. Hey, Google wants to replace the lifespan of your a SSL certificates. That's a interesting, they want to reduce it to one year. That's probably all I'm going to say about that, but just something to keep in your back of your head. If you're in charge of SSL certificates, you might want to, uh, make a note of that. Uh, let's see.
Bill Russell: 01:31 Wide. Let's get to the show. Uh, my name is Bill Russell, recovering healthcare CIO and creator of this week in health it a set of podcasts and videos dedicated to developing the next generation of health it leaders. This podcast is sponsored by health Lyrics professional athletes have coaches for every aspect of their life to improve performance. Yet many CEOs and health executives choose to go it alone. Technology has taken center stage for healthcare. Get a coach in your corner, visit healthlyrics.com to schedule your free consultation. Finally, check out the two new services on the website this week, health.com insights and staff meeting insights is for individuals looking to propel their health it career forward. A, you get two emails a week with insights from industry leaders and then I provide some commentary so that you can apply that in your daily life and a staff meetings for managers.
Bill Russell: 02:14 Looking to introduce your team to new thinking and get the conversation started in the right direction. If either of these, jump off the page at you. Hit the website. Sign up today. All right, so let's get to the news. Epics UGM 2019. Um, I'm going to cover a story here from Eric Lawrenson from madison.com, which is a, the local newspaper. But if you want to get a more in depth detail of what went on, we did two episodes, one on Thursday, one on Friday, Dr. David Bensema and uh, Dr. David Butler, uh, shared in detail. They were both, they're shared in detail. They were kind enough to stop, uh, stopped by on their travels home. Um, David was in the airport and Dr. David, David Bensema was in the airport. Dr. David Butler was at a Starbucks being highly caffeinated as he told me. Uh, and uh, he talked very fast about the things that were exciting about the UGM conference.
Bill Russell: 03:04 I'm just going to hit the highlights here and talk about a couple of things that I think are news and we'll just go from there. So Judy Faulkner reflects on the long strange trip. It's been for epic systems as you would imagine. 40th birthday. They reflected on their start in the basement of an office building at old university avenue. They, uh, they dressed in 1979 gear. I wish I had more pictures of that. I'm going to keep scouring Twitter and Instagram for a pictures of different people that I would love to see dressed in 1979 gear. I think it would be exceptional, uh, from their, uh, humble beginnings in that office building to a workforce of around 10,000 client base of about 400, uh, systems really around the world. So a incredible, incredible, incredible nothing but, uh, um, respect for what Judy Faulkner and the team have been able to do, uh, really from nothing until, uh, today.
Bill Russell: 03:58 Uh, Faulkner lingered on pivotal points, uh, such as a intro, introducing the graphical user interface in 94, uh, which she says is the start of the EMR industry. Uh, might be a little hyperbole there, but, um, it's definitely the start of a different, uh, chapter in the EMR Industry for sure. Um, and, uh, also about around their, uh, efforts to share patient data across different health systems. In the mid 2000, she reflected on a conversation with her husband, a physician who complained that her, uh, to her, that the patients were dying due to a lack of exchange between providers and, uh, and they've built out a really robust, a data sharing platform. They have a care quality, they have a care everywhere, share everywhere. Um, they have, um, gosh, community connect. They, they've a whole host of things, uh, that they built out to share the data across their, um, uh, across the epic ecosystem, if you will.
Bill Russell: 04:58 I think the other thing they really did there, which I'm really impressed with is they, they really led their clients, um, around the importance of sharing that data and helping them to see the, the need to share that data across at least all the epic, uh, uh, users, uh, within that community. So let's see, let's go on here. This year Faulkner spent more time focused not just on the past, but also on the president of portion of her speech, focused on ongoing issues around medical software from the changing regulatory landscape to the growth of third party applications to doctor burnout and productivity. All important issues. We'll come back to that. She also stressed the importance of utilizing epic's vast array of features and applications, many of which are automated and artificial intelligence driven to improve outcomes for patients. She said that epic would soon launch an initiative to have its customers save 100,000 lives through improved use of the company's technology.
Bill Russell: 05:53 So, uh, again, a fantastic, if you hadn't listened to it, Seth Hain VP of r and d for epic, uh, AI was on the show probably about four weeks ago. We talked about a lot of these things. And, uh, I think one of the things that's most impressive about it to be honest with you is, um, you know, there is advancements being done in places like La, Seattle, um, uh, you know, New York, uh, Chicago where you, where you would think there would be advances. But one of the things that Seth really pointed out in that episode was the advances that are going on and, uh, these rural locations because epic has been able to build the AI intelligence into the workflow and into the platform that you're seeing health systems that wouldn't normally do that kind of advanced work, uh, do that kind of advanced work, which is exceptional.
Bill Russell: 06:41 Uh, and then finally, Cosmos massive database with patient biomedical data that epic claims could change clinical decision making. And medical records and a bunch of other things, uh, voice recognition and some other things. I'm going to go back to again, those two episodes I did Thursday and Friday much deeper than what I'm going to go into. Uh, but I'm going to talk about two things here. One is the changing regulatory landscape growth of third party applications. A changing regulatory landscape could be one area where Judy and I disagree, which I've, I've uh, really touched on a little bit on, on previous episodes and um, you know, secretaries are, Seema Verma are really focused in on how do we share data across the entire health landscape. Uh, I think if you were to really push Judy on it, she would say, we have developed a way to do this.
Bill Russell: 07:31 And if everyone were to go to epic, I'm not sure she would be this overt, but I think it's what she thinks. If everyone were to go to epic, if 100% of health systems were to go to epic, we would have the best data sharing platform across the entire country. And you know what, she is absolutely right. Better than any other platform that's out there. If every health system was on epic, we'd have a great, uh, data sharing platform, uh, across the board. The problem is that will never happen. So we have to deal in reality. And the reason that'll never happen, it's because once it gets to a certain percentage of this, federal government will step in and they will break up epic. Uh, it'll just happen. So you can't get to 100% of a market and expect to still be around. So we have to explore other options.
Bill Russell: 08:13 And since, you know, you have these competing platforms and there's really no, um, there's no financial incentive. There's only a sort of an altruistic incentive to share that patient data across competing platforms. That's why the federal government has to step in. And I'm not a huge fan of it. I'm just saying that this is the quintessential a use case for the federal government stepping in where you have to get epic data into a Cerner platform and Cerner data into an epic platform and so forth and so on are across the entire ecosystem or a new, uh, set of data brokers to emerge that everyone has to share data with. A, that's the, that's the work of the federal government is to make sure that markets don't get so constricted that there's only one or two ways for something to happen effectively. So I actually liked the work that secretary AZAR and Sima Vermont are doing.
Bill Russell: 09:09 Uh, it's, it's gonna push epic a little bit out of their comfort zone, comfort zone and uh, and probably to do some things that aren't necessarily in the best interest of epic or it seem on the Cerner side, the best interest of Cerner. Cerner is going to have to be able to, you know, provide access to that data, which makes it easier to move into epic, which in theory makes it easier for a health system to make a, an epic decision and move away from Cerner or to make a Cerner decision to move away from epic. So I understand why, why is a business you wouldn't want to do this. Um, but in the interest of patients in the interest of sharing that data for the same reason, uh, that conversation all, all the way back in the two thousands, uh, I think we, I think epic can be a leader here by the way.
Bill Russell: 09:53 I think there's a, a better path than fighting CMS. I think it's partnering with CMS and, uh, uh, and identifying a handful of players or a handful of ways, uh, that we are going to share information in a way that is secure and in a way that is effective and in a way that benefits the patients and does not jeopardize the intellectual property of anyone who has done a ton of work over 40 years to build this out. So that's one, uh, you know, the regulatory landscape, the second is closely tied and that's the growth of third party applications. The reality is epic can't do everything. Cerner can't do everything. The EHR was never designed to do everything. There is not going to be one killer app in healthcare. There is going to be, uh, that is going to be the core system, which is gonna House, the legal medical record.
Bill Russell: 10:44 But then you're going to have all these ancillary systems and applications that reside around it. It's why, you know, applications like [inaudible] exist so that uh, so that providers can prescribe applications, right? Because there's not going to be one application that wins. There's going to be a ton of them. There's going to be something around orthopedics, there's going to be something around oncology. This gonna be something around. And we need that innovative community to be able to develop. In order to do that, they need to be able to get access to the data. And I'm a huge proponent of the fact that epic shouldn't be making any money on access to that data. I don't think me as a developer of an application should have to pay epic anything but a very small fee to cover their costs. Um, I also don't think that epic needs to worry about the fact that they have to protect that data, um, more than anyone else has to protect that data.
Bill Russell: 11:38 If, if they're, if the federal government is going to force them in this direction, then we have to require the federal government to define what that a security mechanism is going to be to make sure that once epic says, okay, you want us to share the data with them, we're going to share with them, well this is highly sensitive data about my health. I want to make sure it doesn't get used improperly. And I think as Judy clearly articulated in her talk, she doesn't want it to get used improperly either. And so until that mechanism is clearly defined and articulated by either the federal government or someone, someone has to define it and someone has to clearly articulate it. I don't think epic or any health system should be required to share that data. So from that standpoint we are in complete agreement. Let's make sure that that gets defined some way, some, some way shape or form.
Bill Russell: 12:32 Um, and the other in terms of sharing the data across health systems, I think, uh, quite frankly, um, I, I think the federal government does need to step in here and I think in healthcare we need to think differently about API APIs. We, we, we see it as a mechanism for moving data from one system to another where my health data is, can be stored in 75 different health systems. Makes no sense whatsoever. Uh, the way APIs work or should work is uh, uh, sort of a request and retrieve kind of platform. The one we're most familiar with is ups, right? I want to know where my packages, I request the data. I retrieved the data. When you go to Amazon today, it's not, Amazon isn't downloading all that data and putting it into their system. They have a link to the API and ups that tells you where your, your packag is.
Bill Russell: 13:20 That's how that data should work. We should be able to make a request for the data, for the health data, get the health data, not even move it into our system unless we need it for care. And then, you know, process of things and then, uh, allow that data to reside wherever. Uh, I've already talked about this too much onto the next story. Healthcare, finance, news reports, close to one third of healthcare employees have never received cyber security training. The report shows and he goes, sit and talk about this report. And actually all I really need to re read is that headline to say to you, the number one thing you need to get out of this story is 100%. You're the attack vector. That is the easiest to breach is your users. 100% of them need to be trained on cybersecurity and it needs to be constant, ongoing, uh, training on how to use systems. And, uh, that's a, that just is the way it is. So let's go into some of the breaches for this best week. Uh, I thought one of the things that was interesting to me is I hit a story. Which story was that? So that's the, uh, they've never been trained. There's another story.
Bill Russell: 14:34 Where is it? 32 million patient records have been breached in the first half of 2019. 32 million patient records have been breached. Okay. Uh, then we have phishing attack breaches data for 183,000 patients at Presbyterian health system. Uh, that's fishing. There was, uh, a, uh, another attack of another health system in Louisiana that was 120,000 records. And then you had 10,000 patient records at, um, mass general had been breached. And these are all within the last 30 days. And, uh, it's, uh, you know, again, this continues to be a little disconcerting that, uh, this many patient records are being breached. Uh, when we do this, when we allow this to happen, and everyone knows this, I'm not saying when we allow this to happen, it is a, uh, significant, um, uh, violation of our trust with the community and the people that we serve. Uh, you know, this is a, uh, one of those areas where we need to be vigilant.
Bill Russell: 15:40 We need to double down. We need to be training people. We need to be putting the right tools in. We need to be looking at innovations that are happening, uh, around, uh, uh, artificial intelligence across the wire, uh, looking for these things, shutting them down quickly, uh, addressing, uh, exfiltration based on patterns. Uh, you name it. We, we need to be doing this. We need to be getting the budget dollars, the so what on this is we need to be, we need to be training people and we need to be getting the budget dollars. We need to secure the data. Um, because if you can't secure the data, you shouldn't be, you should figure out some other way of, of housing the information you need for the, uh, for the, uh, to, to, to run your health system. I thought one of the more interesting stories though, I, it's Kinda sad that those stories have become sort of old hat.
Bill Russell: 16:31 I'm sorta like, Hey, 100,000 patients here, 120,000 patients here. Uh, but 32 million patients in the first half of the year. That's a startling. But if you think, well, main silicon valley knows what they're doing, they really have this thing down. I read this story. Apple just gave 1.4 billion users a reason to quit their iPads and iPhones according to Forbes. That's not going to happen. But I'll read some of the story for you. Google's project zero security team broke the news, revealing that hackers quietly developed a system which enables disparate ios vulnerabilities to be daisy chained together to gain complete control of your iPhone and iPad. All owners had to do to be exposed as visited a certain website. And Google estimates that thousands of visitors per week did just that once they in hackers had full access to your photos, your contacts, your private messages, and even encrypted data such as passwords held in your ios key chain.
Bill Russell: 17:28 So, um, you know, it goes on, but, uh, I mean you, I would, it's a Forbes article. I recommend you look it up. It's worth looking at. And for those of us who have, uh, physicians and clinicians who use iPhones and, uh, there's a better than average chance they reuse the passwords they use in the hospital on their phone and they save it in their key chain. There's a chance if they've, uh, been breached this way that their passwords have been breached. So again, in one of the hardest ways to, uh, one of the hardest things to do is when people are coming and coming in with the right credentials is to identify, uh, you know, when it's, when the systems are being misused and they're actual trading the wrong data. So, um, you know, this is just something I wanted people to be aware of and, uh, to be planning for.
Bill Russell: 18:21 It's something that should be a part of the conversation that's going on. All right, that's enough about security, uh, bars rising for consumerism in healthcare, but providers are still playing catch up. Jeff, like Gacy healthcare, finance weekly. So many industries these days cater to increasingly online convenience, obsessed and consumer focus world. And while healthcare is no exception, it has a lot of caps catching up to do the results of a Kaufman Coffin Hall's 2019 Healthcare Consumers, I'm index highlight the challenges that legacy healthcare providers face in trying to grasp firm handholds on the ever rising bar of consumer needs and expectations. The index provides a lens into the industry performance related to consumerism based on survey responses from hospitals and health systems nationwide. So the index placed organizations in four main tiers and organism organization and tier one is defined as best in class through tier four.
Bill Russell: 19:19 You get the picture. Hospitals and health systems continue to emphasize building facilities over creating convenience. The report found, while more than half the respondents offer urgence, uh, urgent and ambulatory care, ambulatory care centers only a third offer, widespread basic online scheduling for existing patients. So we're building out new urgent care centers, name of the Tory care centers, but we're not investing enough money to do more than a third are or less than a third are doing online scheduling for patients, which we know is one of the highest desired things within, uh, the uh, digital platforms that we provide. Just 9% of the organizations rated as tier one performers for access down three percentage points from 2018 those in tier two rows, six percentage points over the same period. Um, nearly 80% of the organizations report and having no subscription-based primary care services, a third offer, widespread online self scheduling for existing patients, but few offer this service for new patients same day appointments and extended, uh, and walk in hours are common access strategies.
Bill Russell: 20:27 And 38% of respondents offer widespread safe spot urgent care. A while nearly 6% offer it on a limited basis. This is a great survey by the way. It just maps out, uh, some of the things that, uh, patients are looking for, uh, from their, uh, digital tools and from their health systems in general that digital can really support and streamline in terms of really driving down the friction, increasing the access, uh, and increasing the, the convenience factor of working with your health system. And, uh, you know, for those of us who've been in healthcare for any period of time, all you have to do, all I will have to do this afternoon at our Labor Day party is bring up that I am in healthcare and the people who are here who know that will, uh, tell me their latest healthcare story and they'll say, uh, let me think.
Bill Russell: 21:16 My most recent one, um, you know, first of all calling, it's gotta be one of my hot buttons. Uh, this year is, um, calling in to schedule. Okay. So first of all have to be having you call in to schedule. So they call it, they call into schedule. They get to the place where they need to schedule and they say, oh, no, you're in the wrong place. Let me transfer you. So they, they transfer and once they get to another person and they say, oh, no, no, no, no, they were wrong. You need to go back to the other thing. And they said, well, can you transfer me back? And the answer's no, we can't transfer you back. Our phone system does not have that capability. You're going to have to call back in. So they ended up having to call back in. Um, and you know, the fact that first of all, we should have the ability to do online scheduling for something as simple as it was a mammography.
Bill Russell: 22:03 By the way, here's something as simple as a mammogram. We should be able to sell. We should be able to have online scheduling. But the second thing is these phone systems through a m and a and things that have happened, we've gotten to these phone systems that are so convoluted that we can't, uh, for whatever reason, we can't transfer people effectively across those phone systems. So the consolidation of call centers, the ability to route calls. Uh, and my guess is if your phone system is that antiquated, you probably don't have some of the advanced tools that are available on some of these. I'm not recommending this, but I'm just saying some of these cloud-based phone systems, I have talked to a, especially a retail based health health practices that are using cloud-based phone systems and have phenomenal capabilities in terms of routing and um, and uh, reports and metrics and all sorts of other things.
Bill Russell: 22:59 It's, it's exceptional. So we should, we should have some of those things and a lot of us haven't been able to implement them. Uh, just because the, uh, the, the cost is so high. I can't believe that's 20 minutes already. Here's what I'm going to do. I'll say so. Um, cause I'll probably won't cover these stories. IBM's, Dr. Watson may have had been misguided from the start. I think that's an interesting story. Um, but, uh, pretty, pretty hard to go into that online here today. That is from, uh, AI in healthcare, uh, innovation to transform healthcare. IBM, Dr. Watson, uh, Dave Pearson, article from, uh, August 12th. I think that's a interesting article worth, uh, reading. It's really about what people have been saying for awhile, which, uh, Watson bit off more than it could chew from the get go and really should have been a lot more narrow, a lot more focused, a lot more narrowly, a much more narrow focus would have helped them significantly rather than trying to market and advertise, um, uh, where they were, uh, trying to go where they thought they could go.
Bill Russell: 24:07 Uh, let's see. Two thirds of consumers say they're interested in telehealth, but a far fewer have actually used it or given it a try. This is from a Mobi health news. Steve Muoio, is his last name? August 28th. Um, again, interesting read, worth looking at. Uh, I think it speaks to the fact that there's still a cultural shift and we need to educate the consumers on the value of telehealth and the value of using it and uh, get them to use it for the first time. Much like we did with m u with the portal, uh, the first time around. I, we're gonna have to do the same thing with tele-health. It feels like to me, um, hit infrastructure.com there's a story CD s s could or a clinical decision support systems could replace hrs as clinical interface since frost and Sullivan and uh, that is from again, hit infrastructure.com.
Bill Russell: 25:04 Fred Donovan doesn't have a date, but uh, interesting read worth looking at. Um, anything that gets that sort of kid set itself in the middle between a user and the, uh, backend system a has a disruptive quality to it. Uh, so it's something to always keep an eye on. I already told you about Google's a plan to reduce the lifespan of SSL certificates and I think that's important to, uh, keep an eye on. I'm going to come back probably next week to this story. It's your right to see your medical records. Uh, and it shouldn't be hard to do this. It's an NPR, a story that I, uh, got online worth taking a look at. That's all for this week. Every Friday, check out our interviews with industry influencers are two from last week. Uh, the two, David's, uh, on the, uh, UGM conference. If you want more detail on that, uh, keep the comments coming, bill @this week in health it.com good, bad or different. It all helps. Really appreciate it. This show is a production of this week in health it. For more great content, check out the website this week health.com or the youtube channel this week health.com at the top, there's the, uh, uh, you can click on youtube. You can click on our two resources, insights and staff meeting and, uh, any one of our archive show. Thanks for listening. That's all for now.