This Week Health

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July 8, 2022: A special episode of Keynote this week combines different guests and topics that really illustrate what this channel is all about and what conversations we’ve been able to have the past 6 months. We’ve clipped together some conversations that hit hard, shared innovation, and pursued different outlooks on healthcare and health IT. In Part 2 of our curated playlist, we feature the following guests and topics:

1. Phoebe Yang, General Manager at AWS, Healthcare - AWS's Phoebe Yang Explains How Technology Can Address Disparities in Access to Healthcare

2. Daniel Barchi, CIO at New York-Presbyterian - How Can Vendor Partners Successfully Approach CIOs?

3. Aaron Miri, CIO, Baptist Memorial Jacksonville - Creating a Culture that Fosters Collaboration, Innovation, and Problem Solving in Health IT

4. Nadine Hachach-Haram, Founder and CEO at Proximie - Healthcare Needs to Replace Brick and Mortar with Patient-Centered Care

5. Aneesh Chopra, President of CareJourney - Does the Business Model in Healthcare Drive the Need for Interoperability?

6. Micky Tripathi, National Coordinator for Health Information Technology at Office of the National Coordinator for Health Information Technology (ONC) - Micky Tripathi Explains What TEFCA Means For Healthcare: Accurate And Accessible Data

7. David Feinberg, President & CEO of Cerner - The Power of 'Dr. Google' and How it has Become Better Access to Information

8. Stephen Klasko, Former President at Jefferson Health / Executive In Residence at General Catalyst - Investing in our Future through Population Health, Predictive Analytics, and Social Determinants


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 on This Week Health.

I can say as someone who was working on the front line during COVID never, has there been a more poignant time that has really highlighted the need to change and the fact that we can no longer keep delivering care in a bricks and mortar approach.

today on this week health conference, we have one of our mid-year episodes where we're gonna take a look back at the first six months of this year. We had some phenomenal guests on the show for the first half, and it was fun to just have those conversations. And we wanted to provide you a little glimpse of some of the conversations we had.

And if you hear one that you think, wow, I really should have listened to that whole episode. Go back, hit our website this week And go ahead and have a listen. Thanks for joining us on this week. Health keynote. My name is bill Russell. I'm a former CIO for a 16 hospital system. And creator of this week health, a channel dedicated to keeping health it staff current and engaged.

Special thanks to our keynote show sponsors, serious healthcare, VMware transparent press Ganey, Seus, and Veritas for choosing to invest in our mission to develop the next generation of health leaders. All right, here we go. So, as I said, that was part one. If you miss part one, go back and listen to it. We had mark Cuban. We had John Halamka always a favorite. Angela Yoko Lee Shapiro. Glen Toman was on, we had Missy Krasner, one of my favorites, Rob D mache and Dr. Lee Milligan closed it out in that episode. Today, we're gonna kick it off with Phoebe yang, Phoebe yang, general manager of health and life sciences for Amazon web services.

And we just had a conversation of what are some of the problems that big tech can solve in healthcare. So here you go. Here's Phoebe yang on 📍 that question.

When you look at the healthcare landscape, what are the problems that you believe technology is best positioned to solve today?

Yes. Yeah Bill it's so interesting because I think in the last two years in particular we've just seen a heightened interest in and technology's potential to support really every corner of the healthcare industry. From remote patient care to planning for surges from pre-empting, overwhelming bed capacity at hospitals to research and vaccine development.

And I would say if you think about it, there are areas that I think have really taken off. One of the biggest challenges I've found when I was helping to build and scale a population health business for Ascension was this question of access to care.

And the pandemic only heightened and worsened in some ways the challenges of a lot of people. But especially those underprivileged individuals and families and communities to get in-person provider care and particularly when that care is most needed. So what we saw, which was really super interesting, but also very inspiring was a lot of health systems really stepping up, I think to support telehealth. They broadened and diversified the points and modalities that patients could access clinicians and get the care that they needed. And the goal now is really to leverage what we've learned to advance and not retract those modalities so that all patients and providers who really saw really a better experience can reduce the burdens and and also the burnout factor and to have 📍 better experiences.

All right. Great conversation. Moving on, we had Daniel Barchi, Daniel Barchi last year was chime CIO of the year. He's with New York Presbyterian and out of New York city. And in this conversation, I decided to ask him, he is known as somebody who is. Hard on vendors. I mean really wants them to do their job, to know what they're talking about, to have an agenda when they come in and have, and have a point of view when they come in and talk to him.

And I wanted to really tap his brand on what he's thinking, how he approaches vendors and what, what advice he would give vendors that were looking to work with him in the future. And so here's a clip from this conversation with 📍 Daniel Barchi.

I'd like to offer our vendor partners a little help on working in healthcare and CIO's really have a ton of responsibility. And as a group, they don't like when people waste their time.

And you'll have to pardon this, but you have a reputation as someone that doesn't suffer fools lightly. So, meaning that you don't have patience for vendors or partners that don't have their stuff together or don't do their homework before they come in. And all of us have had that experience. If you're in that chair and you're trying to run real fast, you're managing a lot of people. I guess my question would be, what would you tell vendors that are calling on healthcare CIOs?

I would say that healthcare CIOs are not often the best people to call on because we often have limited resources as our teams are working very hard. And in many cases, we're trying to optimize the tools that we have my recommendation.

And I share those freely with anybody who asks is, know who your customer is. So in many cases, the healthcare CIO is not the best person to be making that sale to. So it might be the CFO who has the vision to know, oh, you're telling me this tool or product could save us X cost on expenses or would increase our revenue by a certain amount. Or maybe it's the Chief Patient Experience Officer. Or maybe it's the Chief Nurse.

Or maybe it's a board member or the CEO who has vision for where we need to go next. So CIO's are often a place where the answer can be no, because it seems like it's competing with the technology portfolio. But thinking only about the technology portfolio misses the opportunity to maximize the benefit of a new idea or new product or new technology for the larger system.

And quite frankly, I might be a person whosay no, that doesn't seem like it's a good use of time or our energy or our dollars. But if our CFO comes to me and says, I just talked to my partner out at this other health system and she's the CFO out there. And she said that they're doing this thing.

Let's investigate it. If our CFO's interested. Good. I'm happy to do it. Or if our Chief Nurse says this would really help, I'm interested. So think about who you're targeting and go to 📍 them first.

I love talking with Daniel again. Fantastic interview. The whole thing is worth going back and listening to, I think it was the first episode we did this year and again, great conversation. Our next guest is another fantastic CIO for Baptist health down here in Florida. And it's Aaron Miri Aaron made the transition from university of Texas.

The. Dell medical school over to Baptist health earlier this year. And so we asked him about making the transition to CIO, but specifically that's what we talked about in the overall episode. In this portion of the episode. What we talk about is the Kronos outage. Which was a big deal across the industry impacted a bunch of health systems and showed the vulnerability that we have in some of the cloud systems and cloud architecture that we've set up.

And so I decided to ask Aaron how they dealt with the Kronos outage. Here 📍 you go.

Give me an idea of the Kronos outage sort of dates when we're recording this. I mean it's really top of mind right now and it's this serious issue. I mean, making payroll and those kind of things.

I had a number of people tell me Aaron, we would like to build apps on the fly that is not encumbered with bureaucracy and all this red tape. We want to just be able to go fast and solve problems. Well, lo and behold, this week Kronos, which is a large time and attendance system was hit by ransomware and so all their cloud services went down. We were a customer of theirs. That ran on the news last night. But we're going to make payrolls, no problem. But we built an app within one day on a low code platform to deploy, to automate timekeeping.

Okay. So my team came up with this in partnership with payroll and others in one day. And we're in the process of deploying it right now. So that once we get past this pay cycle on Friday, starting next pay cycle, we're back to being as automated as possible. And then just doing some QA on the back end while we wait for Kronos to get their act together.

That's the kind of stuff when people say, I want to develop a cloud engineer, okay. Here's a project. Go. Make magic, right. Make magic and have fun. That's the kind of stuff we have to be doing together.

So did you have an environment already in place or did you just walk into the team and say, okay, we've got this problem and they started brainstorming and saying, now I, we could probably develop something on this or this or this?

So we, we started with a true brainstorm session. I call it a hackathon that went about an hour or two hours. So we had a list of about 30 ideas and so I said, okay, which sort these by work effort right. Lowest work effort, the highest work effort. Obviously highest work effort being set up an on-premise and deploy it and all that stuff like that.

Right. That would take weeks. And then this solution came up at the very top. It wasn't the easiest, but it was the first almost I would call it semi-autonomous but mostly autonomous solution that could be deployed within a day.

And I said, okay, build me an MVP in one day. And so this morning at 7:30, I got a phone call from my team saying, Aaron, we're ready to show you. And I'm like, holy smokes, let's roll. Test the heart of it and get it out there. So that's exactly what they're doing. I'm very proud of them, but it was a hackathon.

But that, that builds a culture and ethos that any problem is solvable. If you just simply have the willpower and the mindset 📍 to do it.

All right. Our next guest was Nadine Hachah-Haram founder of Proximie And again, phenomenal conversation. I love what Proximie's doing, really interesting stuff around training, remote surgeries and those kinds of things. Just exceptional company. Great vision that Nadine has put out there. In this, we talk about how healthcare is changing. And so she gives us this brief answer on how healthcare is changing and how bricks and mortar aren't gonna cut it anymore. Here you go. Nadine. 📍 Hachah-Haram

I can say as someone who was working on the front line during COVID never, has there been a more poignant time that has really highlighted the need to change and the fact that we can no longer keep delivering care in a bricks and mortar approach.

In a building type approach. We have to start to evolve healthcare that is decentralized. That is at the point of care. That is patient centered in a sense with all these solutions that can help us deliver that. That is less opaque. That is more digitally connected and more global because we can learn a lot from each other 📍 as well.

Again, I love her vision. It's really big, great episode. Go back and listen. If you get a chance, our next guest is one of my favorites. I have him on at least once a year, and it is an east Chopra co-founder and president of care journey who has been an evangelist for interconnectivity within healthcare, data sharing and interoperability.

And we talk about so many different things when it comes to interoperability, we've done about I think about four episodes together. So far over the life of the entire podcast. And I think you're gonna, if you haven't heard Anish before, when you hear this, you're gonna understand why I keep having him on.

First of all, he's very passionate about the topic of interoperability and data liquidity within healthcare. But in this one, we talked specifically about the business models of healthcare and are they, are they helping the process of accelerating interoperability in healthcare? So here you go. Anish Chopra co-founder and president of 📍 care journey.

I find people oversimplify this challenge and they go, well if we just get the technology, right this all sort of flows together, but it's all of it isn't it? It's the payment models. It's the business model. That's what creates the complexity around it, not just the data and the quality of the data and the movement of the data.

The business model is what drives this and the commentary for me. And I think this is the headline you've heard from many of your guests. The reason we've limited the returns on investment for interoperability is that the demand for interoperability has been relatively low. And it may seem odd because you and I represent digital health and companies that want to enter into the market in which case the need for data is great.

And so there's a high demand signal from the new sort of entrance, but for the traditional incumbents interoperability has mostly been a compliance to publish the data out as opposed to a demand signal for business reasons to incorporate data in. The demand signal to bring data in, I hope is going to grow faster in 2022.

And that's what we want on the dots connecting a demand signal for inter-op will shift, from compliance out to value based care organizations in and that will hopefully create the virtuous cycle of investments iterations to make sure that the 📍 interop works.

Gosh, who better to follow up Anish with than Mickey trai national coordinator for health it for the ONC. And in this episode, I just, I let Mickey just educate us. I asked him all about the interoperability 21st century, cures, TECA us CDI you name it. I asked him about it in this clip here. He explains what Teka means and what it's all about. So here you go. Mickey trai national coordinator for health it for 📍 the on.

What do we need to know about TEFCA at this point?

Yeah. So I think the most important thing to know about TEFCA is A, that it's now available for networks to participate in. And then the question is, well, what the heck does that mean? Imagine a world where you think about your cell phone and think about cell phone systems and let's say that AT&T and Verizon and T-Mobile, weren't connected. All of them great nationwide networks, but each of them kind of a private network.

So if I wanted to call you Bill, I would need to know, well, I'm on Verizon. Oh, you're on T Mobile, we can't talk or we can only text, but we can't talk for example. Now with AT&T it's like, well, I can call, but I can't text. That's a little bit of the situation that we have today in the clinical interoperability world with respect to networks. That there are lots of networks out there and the private sector has done a tremendous job, I think moving forward and putting together networks, but because it's the private sector each of them has got its own sort of peculiarities and its own uniqueness. And so they don't seamlessly connect in the same way that cell phones, for example,

so what the 21st Century Cures act did is say to ONC create a governance model and a model for connecting up those networks so that we have that same kind of experience as a user. Whether you're a provider or a patient or a public health agency how do we create that backbone infrastructure so that you can connect with anyone regardless of which network they're on.

And you'll experience that as being in the same network and you won't have to worry about what's going on in the backend. So that's really the most important part of that I think. TEFCA is more about the backend structure.

There is a backend system that makes sure that your information is accurate, reliable, and up-to-date, and that's what we want TEFCA to be able to do for medical records so that when you show up at your provider, there's the backend system that makes sure that to the greatest and possible the medical records that that provider has access to are up-to-date and reliable so that they have the best information available 📍 for them.

At the beginning of this year, I made a list of five or six people that I wanted to have on the show. And I'm happy to say that I've had at least three of them on the show already. And I just got off the phone with somebody and scheduled another one for later on this year. So I'm excited making progress on my January goals of having these great guests on the show.

And one of those people I wrote down was David Feinberg and a bunch of the CIOs were kind enough to connect me with Dr. Feinberg. I've wanted to interview him for many years ever since he was the CEO at Geisinger and had so many great quotes and you know, just around the need to eliminate the waiting room and all that it represents.

Just so many great concepts that he brought to bear. We ended up talking about his days at Google. We ended up talking a little bit about Cerner. We had to be careful talking about Cerner, cuz they were right in the middle of the acquisition. By Oracle. So again, he was very limited on what he could say about that other than excited about the future and the possibility that it represents in this clip, Dr. Feinberg, and I talk about the the power of Dr. Google and what that, what that means and what the potential and possibilities are for healthcare. So here you go, Dr. David Feinberg, president and CEO 📍 of Cerner.

We joke about Dr. Google and how many people go to it. But there's a power of the reach of that and the simplicity of access to the information isn't there.

Yeah. So about 15% of the 20 billion or so Google searches a day are health related. I practiced medicine prior to Google and that's back to that case where I knew everything and the patient didn't know anything. Then Google came out and man patients came in with printed things from the internet and you're like why did you do this? This isn't cancer.

Like your, you went down the wrong rabbit hole but over time I think the available of good information, and now there's studies to show patients actually do better when they do Google searches and there's evidence that you actually get better care and the docs are going to YouTube before they take out your thyroid to look how to do the surgery. And people go, oh my God, I hate that they're going to YouTube. I'm like, wait, when I was a doc, I had a book in my pocket and I would look at how to put the chest tube in. Now you can actually see up-to-date videos. So it's not only helping consumers. It's actually helping the professional 📍 side too.

think you can see why I was so excited to talk to Dr. Feinberg, what a great mind. And I really appreciate him coming on the show and hopefully we'll be able to have him on again in the future to close this out. We have Dr. Steven Klasko, former CEO for Jefferson health out of Philadelphia. Now an executive in residence for general catalyst.

And just love talking to him about the future of healthcare. One of the things I like is he would write these documents of what healthcare will look like 10 years from now. If we learned the lessons we should, what healthcare will look like. And one of the ones I really appreciated was what the next pandemic will look like because we've learned the lessons of this pandemic.

The next pandemic will look very different and I like his optimism and I like the way he frames up what the future can look like by looking back. At how how it might look to go through some of these some of these events with the knowledge that we have learned over the years. So in this clip, we talk about investing in the future through population health, through predictive analytics and through social determinants. So here you go, Dr. Steven Klasko on investing in the future 📍 of healthcare.

If we knew that during the industrial revolution and the internal combustion engine might cause climate change, we might've made some changes.

If we knew that the social media revolution and Mark Zuckerberg, wasn't just so I could see my unbelievably cute grandkids but it could affect elections and spew hate. We might be in a very different situation. So what we've really tried to look at is how can we invest our dollars in entities that are going to turn things like population health, predictive analytics, social determinants from philosophy to the mainstream clinical care and payment model. So if you look at the folks that they brought in, just one example, company I'm going on the board of that we acquired is looking at how can we revolutionize clinical trials?

Right now clinical trials are stuck in the nineties. We can now comb through an EMR and say for this particular trial B,ill Russell is perfect. Those are the kinds of things that we're looking at that can start to create this ecosystem that de-fragments healthcare hopefully in the United States 📍 and beyond.

There you have it, Steven, Klasko closing out a great episode. I think you'll agree. We've had some great people on in the first half of the year. Mark Cuban, Dr. John Halamka, Angela Yoko, Lee Shapiro, Glen Toman, Missy Krasner, Rob D mache Lee Milligan Phoebe yang, Daniel Barchi, Aaron, Mary. Nadine Hasha Haram, a Chopra, Mickey Tripathi David Feinberg and Steven Klasko.

This is just a phenomenal lineup. And I am just so excited to have been able to interview these people and bring their wisdom and experience to all of you in the community. So that's it. If you know someone that might benefit from our channel, please forward them a note, have them subscribe wherever they listen to podcasts or hit our website this week

We want to thank our Keynote sponsors who are investing in our mission to develop the next generation of health leaders. Those are Sirius Healthcare. VMware, Transcarent, Press Ganey, Semperis and Veritas. Thanks for listening. That's all for now.

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