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What are your predications for Health IT in 2021? I know I'm late, but we've been all vaccine, all the time for January, which is as it should be.

Just click on comment below and let us know. Come on. Make a prediction. It's not a prediction unless you put it on paper before it happens.

Over the next two or three days I will be laying out my predictions around cloud, government emphasis, telehealth, digital health investments and the like. 

Today, Where #cloud growth is going to come from in 2021 and a couple areas where we can almost be sure where the Biden administration is going to take healthcare and we explore the #HealthIT implication for #Healthcare

I look forward to seeing your predictions.

Transcript

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

 Today in Health it, the story is my predictions for 2021. I know I'm late, but better late than never. My name is Bill Russell. I'm a former CIO for a 16 hospital system and creator of this week in Health IT a channel dedicated to keeping health IT staff current. I. And engaged VMware was one of the first sponsors of this week in Health it, and now they're the first sponsor of Today in Health it.

They have been committed to our mission of providing relevant content to health IT professionals since the start. They recently completed an executive study with MIT on the top, healthcare trends, shaping it, resiliency, covering how the pandemic drove unique transformation in healthcare. This is just one of the many resources they have for healthcare professionals for this and several others.

Check out vmware.com/go/healthcare. All right, now onto the predictions. Um, this will probably end up being more than one episode to be honest with you because there's, uh, a handful of predictions and let's just, let's just get right to 'em. My first one is. It's really around cloud and cloud adoption. So, uh, Microsoft is winning the move to the cloud and healthcare.

There's no doubt about that. This was one of my predictions from last year. Covid threw a serious wrench into all predictions, but this one held up in spades. In fact, COVID helped Microsoft. Uh, the reason people go to Microsoft is because it's the incumbent and they make it easy with their renewal agreement to just check a box and get more software.

You know, in, in, in a crisis, MS teams became the go-to platform for remote work and collaboration for just about every healthcare system I'm on. I'm on a lot of team teams meetings these days. Uh, this isn't the only reason they're winning. Uh, they also have a, a tool set that, that doesn't require any change to the existing staff skills when you move to the cloud, or, or at least not much of a change.

Let's just say it that way. Uh, you know, data moved to the cloud in 2020 as well. Um, and that is really my prediction for 2021. There will, there will be the start of a serious move to the cloud for healthcare, uh, and, and specifically healthcare data. Uh, Mayo and Ascension have tapped into Google. Cerner has tapped into AWS.

Providence has a massive agreement with Microsoft, uh, and Health Catalyst, uh, is built on Microsoft for that matter. 2021. We'll, we'll see health systems go beyond extending into the cloud for data platforms. And there will be full on use of the cloud for data tools and cloud data platforms will be, uh, used extensively for non-transactional data requirements.

Uh, this will facilitate multi-cloud data platforms in 2022 and beyond with transactional systems really starting to follow. In 2022 with things like Epic in the cloud on top of IRIS, IRIS was designed for the cloud. Uh, but I think you're gonna see the, uh, performance enhancements and other things that come along with the new architecture.

It's gonna allow Epic to full on. Work in the cloud. So that's, uh, 2021 prediction. I think we're gonna see more cloud data, uh, movement from healthcare. We're gonna see, uh, data platforms start to emerge. We're gonna see cross data platforms and, uh, interesting agreements start to form between health systems to share their data for the, uh, for the good of all.

So, uh, that's, uh, that, that's how the cloud is gonna grow in 2021. Uh, let's look at, uh, prediction number two. The federal health emergency is gonna continue through the end of the, of this year, right? And why is that important? And while it's important because telehealth funding is attached to it, right? So we were all worried during the election, you know, is Trump gonna continue the federal health emergency?

And back then I said, this is the silliest conversation going, this is at least gonna continue through the end of the year. Okay? So we got through the end of the year, we're looking at this and we're saying, where are we at? With regard to number of people who have had covid, number of, number of people who have been vaccinated.

And uh, and then you could just look at it and say, let's make the prediction of how long the federal health emergency is gonna go. And I'm essentially saying we've got another 11 months of the federal health emergency. I don't think there's any rush to pull this thing off. I think we're gonna get stagnated some somewhere around, uh, July timeframe where we have plenty of vaccine, but not enough people lined up.

And we're going to, uh, sort of stutter through that. Uh, we're gonna be stuck at a, uh, I don't know, let's just say a 60% rate, which by the way, will, will be fantastic. Uh, compared to where we are, we were at, uh, in December and where we're at today, um, the, uh, the virus will slow down significantly. But with that being said, the federal health emergency is gonna continue through the end of the year.

So the biggest thing that means for health, it is that, uh, you know, telehealth funding, uh, or telehealth will remain funded at parity for most of 2021. And this is a chance for every health system to really build out their capability with a viable funding stream. So if I told you, look, we're gonna fund telehealth for the next 11 months, so, you know, continue to build out that you have a revenue stream for it, but at the end of 2021, you've gotta figure out where the revenue stream's gonna come from.

Uh, that to me would be a huge opportunity. You're, you're essentially, you're backstopping my, my all my telehealth efforts and, uh. You know, so obviously people are gonna ask, you know, how are you gonna fund it in 2022? Uh, you know, it's, it's really the age old, you know, there will be, uh, there will be lines where CMS comes in and funds they're gonna fund.

Um, uh, behavioral health is gonna be funded, uh, almost full parody. Uh, states are gonna try to jump in. They just don't have enough money, uh, to fund it. Um, but you know, the question is, where's CMS gonna fund it? They're gonna fund it there. They're gonna fund it. They're gonna have a, a trove of information and they're gonna look at where it has been effective and they're going to fund it there.

I think they're gonna fund it around, uh, remote health into, uh, rural and underserved communities, I think will remain funded. So there's gonna be a, a, an actual funding source, but you could also. Look at lowering your costs, improving efficiency and outcomes. And, uh, there's also that, that aspect of, uh, the patient experience and improving the patient experience.

And because we've done that, we can actually draw more people into our health system in the long run. So that's a, uh, that's a significant move. Uh, it looks like I'm gonna be able to get through three predictions and we will, uh, call it at that. So maybe this is a two episode kind of thing. We'll see. . Uh, the last prediction is for today is return to bundles and bundled payments, and I talk about this on today's Newsday show.

The, uh, you know, bundled payments was, uh, really something we saw during the Obama administration and it essentially took things like knees and hip replacements and said, look, we're going to look at all of the organizations that deliver. These kinds of services across a significant geography, and we're gonna see what the cost variation is to deliver the same service.

And so they looked at, let's just say knee replacements. They looked at knee replacements across this large swath and they said, oh my gosh. Look, I mean the, the disparity's huge. Here's what we're gonna do as CMS, we're gonna say. A, a bundle for knee replacement starts at diagnosis and ends at when you're actually walking without a walker or a cane or that kind of stuff.

So it ends at full recovery and we're going to a, a assign a certain amount to that, and it's gonna be based on, I don't know, the mean or the average for a certain geography for delivering that service. And that was, that was the norm during the Biden, uh, during the Obama administration. And therefore, it's not hard to extrapolate.

That will probably be the norm. Uh, coming into the Biden administration, we're gonna see a return to bundled payments. Uh, so, you know, what does that mean for health? It, well, bundled payments are hard and they're hard for a couple reasons. One is, you know, you might be one of the people that's above that mean or that average, in which case you're gonna have to look, look at driving your cost down.

Uh, the second is you have to, you have to orchestrate, uh, the care. And a lot of times that care starts before your health system gets involved and it ends after your health system's involved. So it stretches your capabilities, it stretches your digital capabilities, it stretch stretches your health system's capabilities.

You have to figure out a way to deliver. Uh, you know, good. I mean, it's really not at the diagnosis stage. That's actually the easy part. The hard part is, is really after it's the rehab, it's the, it's the rehab facilities and, uh, where it's in a lot of cases were not owned by the, by the health system, in which case you had to manage quality.

You had to pass data along to those facilities, and you had to manage the delivery. Uh, so that you didn't have any complications or those kind of things. 'cause quite frankly, your payment is fixed. You're not gonna get any more than that payment. Therefore, you had to make sure that you were within or below that payment.

And so, technologies play a huge role. They play a huge role in a couple of ways. Uh, we talked about data and, and, uh. Transporting the data across the entire continuum. That's obvious. But the next one is, is really the, uh, the, the whole recovery mechanism. I think you're gonna see, uh, a lot of different tools driving care out of the home, and how are we going to be able to, uh, ma manage and orchestrate the entire experience?

So that is multiple touchpoint with technology to determine pain, to determine, um, you know, complications, uh, to have people come back at the right, uh, time. So you, you'll have, uh, the types of digital tools where you're checking in with a patient on, uh, almost a daily basis, if not every other day. Uh, digitally so that you can track that patient from beginning to end to ensure that you are going to get the outcome that you need.

So, again, not rocket science, but 2021, you'll see a return to, to bundled payments. I don't know what they're gonna bundle next. That would be a good prediction. I should, I should probably think about that. Talk to some people, figure out what they're gonna bundle next. But, uh, um, you're gonna see follow through on that and that is where we're gonna go.

And, uh, so, you know, be building out those capabilities, be thinking about those capabilities. Just dust off your playbook from circa, what was it, four or five, five years ago? Well, four and a half years ago. And, uh, see what you were doing then and continue that movement. 'cause you know, the minute the, uh, bundled payments really weren't enforced and moving, uh, at full steam, I think a lot of health systems just stopped, uh, their work on it.

So. Time to dust it off. We'll see where it goes. Alright, that's enough for today. If you know of someone that might benefit from our channel, please forward them a note. They can subscribe on our website this week, health.com or wherever you listen to podcasts. Apple, Google Overcast, which is what I use, Spotify, Stitcher.

You get the picture. I. We want to thank our channel sponsors who are investing in our mission to develop the next generation of health IT leaders, VMware, hillrom, and Starbridge Advisors. Thanks for listening. That's all for now.

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