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Episode 1 - Bill Russell JPM 2018 Healthcare Conference Review

[00:00:00] Bill Russell: [00:00:00] Welcome to This Week in Health IT where we discuss the news information and emerging thought with leaders from across the healthcare industry. This podcast is brought to you by Health Lyrics. This is episode one. My name is Bill Russell, recovering healthcare CIO, writer, and consultant with the previously mentioned Health Lyrics.

[00:00:30] [00:00:30] That's right. This is episode one. This week, we were going to discuss the podcast itself and take a look at the JP Morgan healthcare conference. So let's get started episode one. I'm reminded of the story, actually, just a quick side note of a story that the CEO of Geisinger shared at the JP Morgan conference.

[00:00:50] And he was talking about, he had a meeting coming up with the great grandson of the first. patient [00:01:00] for that health system ever for the health. So many jokes who is admin, how do we even know that this guy was our first patient? And she is obviously a very diligent person, maybe a CSI fan.

[00:01:14] And she went out and produced his medical record, which had the number in the upper left-hand corner. You guessed it. Zero, zero, zero. One, she also produced a picture of the person. I think she was going to meet [00:01:30] their father in the arms of the founder. So even medical record numbering has to start somewhere. It has to start at one, so we will do the same.

[00:01:41] So we're launching a podcast. Why do this podcast? Well the answer to that is, is really founded in a pretty simple answer. I was the CIO of a $6 billion health system in Southern California. Experiencing all the things that a large health system [00:02:00] CIO has to handle and have to deal with people, operations, budgeting, strategy, innovation.

[00:02:07] Each one of those categories for me had like 20 things underneath it. At one point I was using mind maps to just make sure that I captured all the things I needed to be thinking about and working on. And it got to the point where I needed to use a four paper just to print it out and fit it into one piece of paper.

[00:02:27] And the point being that the [00:02:30] role of the healthcare CIO and the role of the CIO is, is very busy. And as a leader in the technology space, my responsibility was not only to ensure the smooth operation of the health system prepare for the future, but also to stay current and educate as many people as possible.

[00:02:49] In the organization about what we could be doing with technology. What, what, what could, what were the possibilities on top of, on top of [00:03:00] analytics and machine learning and blockchain and all these wild technologies that were out there, how were we going to take them and apply them to healthcare? So the job is broad.

[00:03:10] There's a lot going on and And there's an awful lot of people that you have to bring along on that ride with you. So I created this podcast for you. For those of you who are tirelessly working on making healthcare better in all the communities around the world. [00:03:30] It's it's really for the healthcare executives.

[00:03:32] Wanting to know more about it and technologies for the CIO who wants to hear from their peers and other leaders in the industry, hear what they're saying and what they're doing. It's for it, staff who want to further their career, maybe get a little inside knowledge. How, how CEOs think and, and how things sort of transpire within, within healthcare.

[00:03:54] And obviously it's for clinicians and healthcare workers at large, who are [00:04:00] interested in the world of technology and its impact on healthcare. So that's why we're doing it. So let's talk about what we're going to do every week. Following this week, of course, I'm going to invite a healthcare executive to join me on the podcast to discuss the news of the week.

[00:04:16] We're going to use the news of the week, really as a backdrop for creating a dialogue around the the things that are relevant, the things that are happening in our industry that are impacting our industry. And we could talk about things that are [00:04:30]very specific around technology emerging trends and those kinds of things.

[00:04:36] Or we could talk about. Leadership. We could talk about a lot of different things just to give you a little taste for if you wanted to learn more about digital transformation, there's nobody better than David Chou. Who's the is one of the leading voices for digital transformation on Twitter and on social media.

[00:04:52] And he speaks a fair amount. He's the CIO at mercy. Children's in Kansas city and he will be joining me next week. [00:05:00] And I'm really, really excited about that. In fact, David has agreed to be a co-host every four weeks taking into account that he has a full-time job. He has agreed to join me every every four weeks on a Friday for about 30 minutes, which is just to discuss the news of the day.

[00:05:20] And we will share that conversation with you. As another part of the story for me is I came into [00:05:30] healthcare and immediately put on about 30 pounds within about 18 months of being named the CIO for a health system. It was kind of ironic, but this is my gift to those of you that like to. Listen to things while you're on the elliptical or the treadmill.

[00:05:45] You, you want a whole bunch of information sort of compacted so that you can, you can hear what's going on, get, get current and just move on with your day. And that's what we're going to be doing every Friday 30 minute conversation with a healthcare leader, obviously every four [00:06:00] weeks, it will be David Chou.

[00:06:00] I've invited some of my other friends, and I'm really excited for you to meet them, to hear from them, their dynamic, engaging leaders that are doing some really fascinating things within healthcare. And I hope you'll come back every week, subscribe and and join us. Maybe take us to the gym with you.

[00:06:20] Okay. So now onto the JP Morgan healthcare conference, the conference itself is held in San Francisco at the Western St. Regis. It is [00:06:30] a huge event. The, the JP Morgan portion of it, maybe isn't as huge as the, just what happens in the city of San Francisco. There's a whole bunch of. of events that have sort of kicked u p in the area just around the JP Morgan conference .

[00:06:49] So you have innovators meeting with money people, private equity with venture capital, and just all sorts of really interesting dynamic conversations going on. I, of course, [00:07:00] did not go to the really cool fun conference that you get to where. You know, you get to dress down, wear your jeans and look real cool.

[00:07:10] I went to the, the the suit and tie crowd on the 32nd floor of the Western St. Regis for a day and a half. Of the nonprofit track and it is as sexy as it sounds, the nonprofit track, but I have found that to be a really interesting [00:07:30] place to hang out, to learn about what's going to what's going on today within health systems and what's going on within the industry and where it is going to be going.

[00:07:40] So let me again, let me paint the picture a little bit for you. Each each health system is given about 30 minutes. Oh, not about 30 minutes. I that's that's misnomer. They are giving exactly 30 minutes. It's like a Ted talk. You cannot go a minute. Over those 30 minutes, it usually starts with the CEO [00:08:00] presenting things like accomplishments and their plans and insurance.

[00:08:03] Some really cool stories about what they've been able to do for the health in the communities that they serve. And then the last 10 minutes or five or whatever they decide. But it's usually handled by the the CFO. And the CFO will present a series of slides around the similar, all the systems will present the same metrics.

[00:08:24] So you can see you know, their cash positions. You can see. [00:08:30] You could see admissions, you can see all sorts of things and why do they do this? They do this because it's an invitation only event. You will have institutional investors and bond holders sitting in the room, listening to these health systems to determine whether they're going to buy the bonds that the health systems are selling.

[00:08:46] And the health systems generally sell the bonds to finance their debt. And as you know, it costs a lot of money to run health systems. This is very important to them to get their, their, their financing done at the best rates possible. [00:09:00] So they present some really interesting information and it's really kind of cool to see 22 health systems, non-profit health systems in a row.

[00:09:09] Just get up there and present, Hey, here's what we've done. And here's, what's going on. Let me give you a little feel for who was at the conference this year, who presented. It was kicked off the first day at Baylor Scott and white health Intermountain healthcare, Northwestern medicine, Geisinger health system, dignity partners, health care system, [00:09:30] Cincinnati children's Chi Catholic health initiatives, Adventist health system mercy health out of Ohio, Florida, blue Henry Ford health system, Parkview health system, Phoenix children's hospital.

[00:09:46] University of California health. And that was the first day. The second day was looking this up. Let's see. Second day was started off with essential then [00:10:00] advocate health in Chicago. UWU health w a university of Wisconsin, Madison. Hospital for specialist special surgery, the neatest little hospital you haven't heard of out of New York and suburbs of Jersey.

[00:10:16] They're actually expanding Aurora health wake med, and then Northwell finished it up. So you have 22 presentations all going on right, right in a row about 30 minutes [00:10:30] segments. And it, it was, it was really fascinating. I learned an awful lot. Let me, let me just jump to that real quick. I actually, if you're wondering, I did write, write about this on the health alerts blog.

[00:10:42] I wrote a summary of some of the things that I'm going to discuss right now. So here's a couple of themes. The obvious one is mergers and acquisitions. It's it's about scale. It's about, it's about growing to greatness. Let me give you some of the ways that these [00:11:00] health systems talked about growing the greatness.

[00:11:02] The first was a joint operating agreements. Some interesting stories around that most interesting being UWU Madison, really taking The population health too, to an interesting level in terms of partnering with a competitor in order to relieve pressure on their hospital and to provide additional services, the JOA was really well done.

[00:11:27] If there's anything written about out it out there, [00:11:30] it's worth reading. I've I've not seen anything yet, but them sharing the story was, was very fascinating. I liked the way they did it. New access models. Tele-health digital hospitals. I'll talk a little bit about the internet digital hospital. I think that's fascinating.

[00:11:44] Tele-health is starting to reach critical mass you're you're seeing the DOD. You're seeing some other things start to take off. You're seeing changes in regulations and how it's handled across certain segments. And so [00:12:00] telehealth was talked about a lot. Geographic expansion is another way that the health system to grow into grant to greatness, physical hospitals are still being built.

[00:12:09] If you doubted that it is still happening, but more what's happening is retail locations trying to get to where people are without getting into very expensive physical buildings. And I, one of the more interesting things, not for all health systems, but for some of them was international [00:12:30] expansion, new locations and international outside of the U S and destination medicine.

[00:12:37] Some of the health systems are talking about how to make them more attractive to people looking for destination destination medicine. So the I, I wanted to hit on the Intermountain digital hospital real quick. So what they're doing is they're taking a hundred service offerings. This is a building that is not a hospital.

[00:12:59] It's a [00:13:00] building, they're calling it a digital hospital, but it doesn't have any, ER, it doesn't have it doesn't have all the. The normal things that a hospital would have, it's all digital. So a hundred digital service offerings that they are going to take their services locally, regionally, nationally, and really beyond that.

[00:13:17] Now they didn't go into a lot of detail, but they could potentially partner with people in, in certain markets. They could potentially compete with people in certain markets. So it's interesting to really think about where this might go. [00:13:30] So the healthcare consumer has finally broken, broken, free, broken through Every presentation had some aspect of the healthcare consumer that we are now starting to think about the care journey and how do we make it easier.

[00:13:46] And how do we remove the, the friction of transactions and, and how are we looking across the entire continuum? So the, the, the mind shift has, has happened. We're not talking about [00:14:00] patients anymore. We're talking about people who are looking for, for healthcare that are actually. I have high deductible plans.

[00:14:06] They're looking for the best price. They're looking for the highest quality and they are consumers. They're doing research and they're, they're likely people interesting things around that. A lot of people are doing digital transformation initiatives, a bunch of technology. But also a lot of really patient centered forums dialogue.

[00:14:30] [00:14:29] What do you really want from us? Really trying to craft an experience for the consumer. Very interesting, very exciting to see that many health systems talking about it. One of the things I touch on is operational excellence is not really a strategy anymore. It's an imperative. Every health system talked to in some way about tightening their belt and really looking at ongoing operational efficiency.

[00:14:54] One of the more interesting things, there was a RPA robotic process automation, which [00:15:00] essentially has used within their call center to drive out. I don't have the number in front of me, but it was either 40 or $80 million in costs. Significant significant material number in costs through RPA they've since packaged that up, they take that out to the market as a service offering.

[00:15:19] And they're not only selling that within health systems, but they're also selling that service outside of health systems. So clearly RPA is something to keep an eye on and probably something we will cover more [00:15:30] in the podcast as we progress. Population health 2.0 is on full display. Obviously, anytime you have Intermountain and Geisinger speaking, they they're at the forefront of this of this concept of population health.

[00:15:46] 2.0 Geisinger has really dedicated a significant portion of their conversation. Just talking about their population health initiatives and some of the neat [00:16:00] stories that they have going on. One of the stories I share is around food. We all know that food is so critical to, to health, but there are certain places that, you know, your zip code doesn't really lend itself real well to getting good quality food and you don't eat real well.

[00:16:18] And so they've, they've put some non-licensed Chas cha he kept saying chop community health associates out into the field and they are working with [00:16:30]working with people around their diet. They're even giving in some cases, giving them free food. And they're seeing a significant improvement in terms of reducing readmission and costly outcomes.

[00:16:43] Intermountain is Has I, again, I find what they're doing fascinating. So Intermountain has selected two high risk zip codes and what they are doing is they have said, we know that we're going to have to be able to deliver population [00:17:00] health at some point in our future. So what we're going to do is we're going to take two of the most difficult zip codes for us to deliver care in.

[00:17:06] And we are going to attack that there they've partnered with the state. They're assuming risk for the Medicaid spend. And they are now trying out a new methods and approaches to really improving the health of individuals within those zip codes. Very interesting. If there was an opioid stock that you could buy, I would say short, it [00:17:30] short it today.

[00:17:31] Every health system, not every, but most of the health systems talked about the steps that they are taking. To really reduce the use of opioids and they've really declared war on, on this epidemic as it spreads across the U S so some interesting programs, but definitely some, some aggressive system-wide goals are being set by these by these leaders around the opioid epidemic.

[00:17:58] And I [00:18:00] expect to see some significant progress in that area, just based on the. On the, the programs that were discussed and the things that people are doing. And then I think that, you know, the final thing I talked about is that the leaders are starting to mainstream genomics. We had at least four presentations really highlight genomics.

[00:18:18] But we had one health system talk about how they are starting to drive whole exome sequencing, to be a standard practice, to [00:18:30] To really address preventable conditions, very exciting stuff. Look forward to hearing next year. What they talk about should be, should be very interesting. So have a couple more things in the article.

[00:18:42] You can go to health lyrics.com under the blog section too, to read the rest of the article. I also talked about bill Gates you know, very interesting at the end, they asked him you know, what is his greatest indulgence? And he said, not flying commercial. And [00:19:00]they asked them, is there any job you wouldn't be good at any.

[00:19:02] He said, you know, just about every job he wouldn't be good at. And you know, in a lighthearted moment, but a really true moment. He said you know, he just, now that he's done what he's done, really trying to solve world hunger and, and eradicate these diseases. It's kind of hard to go back to, you know, jobs that are have too much mundane in them.

[00:19:26] I mean, he is really working on some. Really fascinating [00:19:30] things. The, the Gates foundation is always always interesting to watch and keep an eye on. So that's that's all for this week. I wanted to keep it short and sweet. We we we'll be back next week or their child will join us and we will discuss the news from the week before. Look forward to seeing you then.