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May 7, 2021: Today is a very special episode. It’s our 400th show. How far have we come in healthcare IT over the last three and a half years? Tess Kellogg, Director of Marketing at This Week in Health IT joins Bill to celebrate the insights of our incredible community of contributors including David Bensema on telehealth, Dale Sanders on architecture, David Chou on ransomware, Tressa Springmann on Apple Health, David Muntz on handling talent shortage in IT and Ed Marx on life, death and everything in between. You’ll also get a behind the scenes look at building up a podcast from 28 downloads to over 250,000 in one year alone. What were the conversations in 2018, 2019 and 2020? The pandemic was tragic in so many ways. And yet for healthcare it seemed like it shocked the system in a way that it needed to. The healthcare industry has achieved things over the past 12 months that were never thought possible. 

Key Points:

  • There’s no way the average American can understand pricing and what they're getting themselves into when they walk into the hospital [00:17:25
  • 2018 will be known as the high water mark for reimbursement for healthcare [00:22:10
  • 2019 was “Grow to Greatness” [00:22:24
  • 2020 was all about clear focus which led to digital transformation [00:32:30
  • What the pandemic really catalyzed in healthcare was external pressure [00:37:50
  • 2021 is about 21st Century Cures, information blocking, AI and machine learning [00:40:50
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.

 Thanks for joining us on this week in Health IT Influence. My name is Bill Russell, former Healthcare CIO for 16 hospital system and creator of this week in Health. IT a channel dedicated to keeping health IT staff current and engaged. Today we have a special episode. It's our 400th episode, and we're gonna take a look back At the last three and a half years, we're gonna see what we were, we've been talking about over those three years.

What were we talking about three years ago? How far have we come? Who have we had on the show? What, what did they have to say? And really celebrate their contributions to the community over that time. You're also going to get a little bit of a behind the scenes look at building of a podcast from 28 downloads from our first episode.

And I wasn't sure I was gonna do episode number two to, uh, really over 400 something thousand downloads in the last three years. Special thanks to our influence show sponsors who are investing in our mission to develop the next generation of health leaders, Sirius Healthcare and Health lyrics. And since this is our 400th episode, I wanna call out our channel sponsors as well who are investing in that same mission.

They are VMware, Hillrom, Starbridge Advisors, McAfee and Aruba Networks. Today I am excited to introduce Tess Kellogg to you. She is the executive editor of this Week in Health. It, uh, writer and head of marketing and other duties as a side. Thus is the nature of a startup. Good morning, Tess, and and welcome to the show.

I. Good morning, bill. Thanks for having me. As if you had a choice. . Yeah, this is, we had to figure out how to do this 400th episode. We talked about a lot of different things and, uh, and quite frankly, I, I wanted to have you on the show. We have such great conversations off the air. I thought, you know, people would benefit from the conversations 'cause you're

Fairly new to healthcare, let's say about a year or you're about a year into your healthcare tenure. Is that about right? Yes. Yes. Uh, you poached me right out of, uh, well, I had quite a few industries before that, but, uh, if it makes you feel better, a lot of them have the same issues that healthcare faces today.

So it's, it's, it's interesting because, um, yeah, we now have, we now have, uh, three staff people. Who are in addition to myself, there's three staff people. We have, uh, three contract writers as well on the staff. So we're, we're growing. Um, but one of the things that I, I think happens as people do this for some period of time is you listen to every podcast episode because that's part of the nature of being the executive editor.

You, you, you come up to speed real quick. You get to hear from . Uh, you know, industry leaders from John Lanka, Darren De Work, and you get to hear from Aaron Mary. You get to hear from Tressa Springman. You get to hear from just these, these great leaders, and we're having this conversation and you're reviewing all this material.

And, uh, it, it's really interesting. I. The, the conversations we had early on were, I'm not really sure I understand healthcare too now. We have some pretty, pretty, uh, dynamic conversations around, uh, what healthcare could do better. It's, it's been fun. Yeah. And I, I made a joke about that the other day about how I think I, I deserve some sort of, uh, accreditation because of my exponential growth listening to this show.

And, uh, Drexel Ford also told me I deserve hazard pay. Ill listen to you two, talk to each other every six weeks, so we can talk about that later. The, uh, and we'll have to think about that this week in Health IT accreditation, if you listen to, you know, 20 or more shows, 30 or more shows a year, uh, you get an accreditation of some, some kind.

But today we're gonna turn the, turn the tables a little bit and you're gonna be the host. Uh, you're gonna get to ask the questions, and I'm gonna tell the stories and stories of really the beginning of the podcast and. Uh, you know, just, I think what we're gonna do is we're gonna step through year by year.

We're gonna talk about 2018, what were we talking about? 2019? 2020. And just move on from there. So I'm gonna. Hand it over to you and, and let you ask questions. What, what, what would you like to talk about? Yeah. Well, with 2020, we definitely saw the explosion of podcasts, right? I mean, everyone and their mother saw the opportunities that were there to start sharing insight and focusing on industry innovation.

But I mean, you stepped into the scene in the beginning of 2018. So do you wanna, uh, podcasts were big, but they aren't nearly as big as they are now. So how did you end up. Where you're at. How, what compelled you to do this to yourself? You know, it, it, it, it is interesting 'cause it, it just, it seems like there's a new podcast every week popping up and, uh, there are a ton of them out there.

But, you know, when I was the, the CIO for, at St. Joe's, we had, uh, 700 staff in, in the IT department. We had 150 contractors. We had 18,000. Total care providers across St. Joe's and I beca, I really became aware of two things. First is I, I was in a position to have great conversations that I wish more people were privy to.

And I would talk to, like former NSA staffer talking about security or i'd, I'd be sitting there around a round table with five or six other CIOs. And we were talking about their strategy and what was working and what wasn't working, uh, I'd get a chance to sit across from CFOs and other industry leaders.

Uh, discussing their hopes and dreams for healthcare and where it could go. And, uh, and I, I just sat there and I thought, man, I wish my entire staff could hear this. I wish my entire health system could hear this conversation. And too often they don't get a chance to do that. 'cause not everybody goes to a conference.

Not everybody gets to sit at that table. And I, I recognized that the value of those conversations I wanted to bring to more people. That was the first thing. But the second thing was that, uh, every day it seemed like. My staff could use a boost in terms of staying current. And let me tell you what I mean by that.

I did consulting for the better part of 20 years of my career and I consulted for great companies in, in finance and manufacturing, defense, aerospace, uh, consumer goods. And, and I got to see how they were applying technology to efficiency problems to consumer experience, to marketing, to supply chain, to just about any area you could think about.

And it felt like every time I got on a plane I was getting smarter 'cause I was getting introduced to all these new concepts of how different industries were doing things. And as I looked around my staff, I realized, and, and for me as the CIOI was so focused on what was going on in healthcare, so focused, I.

On the problems that were in front of me, that it was hard to stay current and I wasn't spending the time to stay current. And so that's the second thing I really wanted to, to address. And so we started a podcast early on to address those two things. And uh, you know, as you know, the mission amplify great thinking to develop the next generation of health leaders and propel healthcare forward.

And what I do now is I read everything I can find. If I think, uh, someone says something really interesting, I invite them to be on the show. And I, I assume that you aren't reading the stuff I read, so if I have them on the show, you're not hearing it a second time, and I ask them different questions. I ask them questions, not from a reporter perspective, but from a, uh, former CIO perspective or from a former, you know, I'm a former chief technology officer as well, so I, I have a technology background, a, a business background.

And, and we just try to keep bringing those kinds of things to light. I guess the second part of your question really is, you know, why keep doing it when there's so many podcasts? And I think the, the reason is because there's so few focused on health, it, the, they may dabble in the in topics from time to time.

They may even have a healthcare CIO on, uh, from time to time. But it's interesting, I've been told several times. That you misnamed your podcast, that you calling it health. It is old and it means that, you know, I'm dating myself and eventually it's gonna be the end of the show because we're, we're, you know, tied to what's old.

And I, I think it's only, I, I, I wanted it to be clear who we created the podcast for. And I don't think the name really matters that much. The, the fact that we have health it instead of digital health or, uh, health innovation or anything to that effect. Uh, because those are the topics we're talking about.

That's what we're bringing to health. It is the topics and conversations around that. So I. If, if, if I thought, you know, we were being redundant and there was no need for our show, we'll stop doing it, you know, the next day, quite frankly. But I still think there's a great need for it. There's a lot going on in healthcare and, uh, quite frankly, people are still listening and, and the response is great, so we're gonna keep doing it.

And if you have any problems with, uh, branding or anything like that with your name, you know, I'm the one who's gonna have to deal with it. So, yeah. That's interesting. Since we brought you on, you haven't told me we need to rename the podcast so that that's a. I think there is something with digital health that has a lot of question marks around it and it doesn't tie directly to an IT team.

I mean, I was listening to our first few shows. I wasn't on the team until 2019, so I hadn't listened to a lot of our earlier. I. Podcast and I listened to our first few shows, and it's in the second show. You and David Chow, were sitting down and debating what is digital? Who, who owns digital in an organization?

Is it the marketing team? Is it the IT team? Is it the COO? And your argument was that it has to be owned by ACEO. Because it has to be actual vision for an organization as a whole that each of those departments can step into. And so I think that ideally digital permeates an organization much beyond the IT department.

So I think it, uh, makes sense that we are honing in on equipping those specific staffs in technology. But I think you're right that digital is, uh. Something far greater than we can, you know, Tess, I, I'm, I'm really, I'm sad that you listened to that first episode because I know, I know how much you've pulled our quality up as an organization.

you're probably sitting there going, how did he put this out? Um, to be honest, the, the first episode was, uh, I pulled, picked up my iPhone. I went over to voice recorder. I hit record, and I put on microphone.

Of our recording capabilities at the first episode. So it's really, well, I will say I had my computer and the internal micro or volume turned all the way up and I could barely understand it. So, uh, I'm glad we've come so far that you now have your own little setup over there. But speaking of those first, uh, few topics, what was the conversation?

Where was the conversation at in health it in 2018? You know, that's, it's, it's interesting because I know for you it's gonna feel like we're talking about the same exact things because to a certain extent we're, but we're talking about 'em in little different ways. Uh, you know, I, I, I pulled up our website.

I'm looking at all the, all the images. 'cause early on we did, uh, actually for, we still do. Whoever the guest is, we have an image of the guest. So I, I remember what we were talking about David Chow. We were talking about that first, first episode. We were talking about ransomware, David Sma. We were talking about the role of the EHR and how the EHR was leading to physician burnout and that that's, you know, we're still talking about that today.

Uh, Che and I were talking about the role of women in healthcare and how important it.

Uh, you know, that first year Drex came on a handful of times and we have some really good conversations just, uh, around a lot of different topics. This is what I like about Drex, is we, uh, he's one of those people that I can drift off and just talk about. We can talk about data, we can talk about leadership, we can talk about blockchain.

We can go in a lot of different directions, which is, which is kind of fun. Um, my gosh, this is, this is a stroll down memory lane. Charles Boise came on. We talked about adoption of. Healthcare. A little later on that year, we had Dr. Anthony Chang on who, uh, heads up, uh, the, uh, med AI platform now, and, and, and he talked about AI and where we were at with regard to that.

And we're still talking about that. We, John Halamka, we talked about cloud, the adoption of cloud. We talked about, this is the first year we talked about the adoption, and that's when he made infamous quote, the role of the has changed. Totally. And, uh, now we didn't see that come to fruition until I think this past year through the pandemic, but we've seen a lot of changes, a lot of CIOs.

Uh, it was recognized during the pandemic, what they bring to the organization, and how many areas that the CIOs interestingly positioned to see every aspect of healthcare because technology.

The data touches every aspect of healthcare. And so they have a unique perspective, and a lot of CIOs saw their roles expand. Anise Chopra came on and, and at that time we were talking about, uh, 21st Century Cures and, and what that was going to mean. And one of the things that he's always said to me is, this is a, this is a long process and enough information.

And that's gonna mean big motion. Couple of great, uh, uh, women leaders in, in, uh, healthcare. Jamie Nelson was on Sarah Richardson, Tressa Springman. And we talked about, uh, you know, the consumer experience. We talked about, uh, the, uh, clinician experience. We talked about, uh, just a lot of different topics.

They were, they were phenomenal. Um, gosh, Dale Sanders, we talked about.

Uh, uh, Chad Brizendine came on and actually shared a lot about building out a consumer experience. One of the things he had done was break apart the, um, the Epic MyChart platform, and then built the wrapper around it. He was one of the, one of the early adopters of really building out that wrapper around it, and I think it paid dividends during the, uh, during the pandemic and on and on.

Rodman. And, uh, talked about, one of the quotes I remember from him vividly was that the, the, the, he believes that the patient owns the medical record. It's a record about them and they should own it. I, I, I think that was a fantastic conversation. Lee Milligan and I first met this year. I, I, I sort of picked up on him in social media.

I reached out to him and said, Hey, will you come on the show? And he has since become a, uh, you know, a regular on the show, but really a great friend and someone I bounce ideas off of. Um. Uh, gosh. Daniel Kraft, we talked about Singularity University and we talked about the, the, the work that they are, uh, doing there.

He has the exponential med conference that's going on. It's the first time I was introduced to Nasser, Demi over at Jefferson. Craig Richards came on. Um, gosh, Daniel Bar came on and.

Tend to the same topics, but with a, you know, a little bit, a little bit more progress than what we were talking about back then. Yeah, I mean, it is incredible that not only do many of those names recur in 2020 for us, but 2021, because I know a lot of those individuals. And while I knew you in 2018, I was, I was not listening to the show, uh, as religiously as I do now.

So, uh, it's encouraging to see the community. Lemme give you an example of, so, you know, we still talk, we talk about this all, we still talk about the moves of big tech, right? So Apple and Amazon, every, you know, every couple of weeks we, we talk about something with am Apple, Amazon, Google, you name it. They, they always keep coming up.

And in that first year we were talking about, but in that first year, uh, 2018, apple introduced their medical record. A lot of health systems signed onto that. And so for the first time we were talking about getting your medical record out of the EHR down into your iPhone and being able to carry it around.

Uh, so that's what we were talking about with Apple at that time. The, the big Amazon move in 2018 was the formation of Haven and Haven, JP Morgan, Berkshire hath, and um, Amazon came together to try.

Handle care for their, uh, for their staff and for their, for, for the population that, that, that works for them. And uh, as you know, because you were around recently, uh, that came to an end and it really is like a time capsule, but it's also a perspective. I mean, if you have the time, these episodes were shorter.

Uh, than they are now. So going back and listening to a 20 minute where we were at three, four years ago is such a great perspective for, oh, how much progress have we made? Or, I. Are we still spinning our wheels on the exact same thing? It was interesting on one of the shows, it must have been, uh, the second episode where you were sitting and talking about your experience coming into healthcare as ACIO and how you had to sit down for eight hours straight with some of the smartest people in the room just to understand pricing and healthcare.

And in that, you realize there is no way. That the average American could understand pricing and what they're getting themselves into when they walk into the hospital. And that was such an interesting thing to hear because the last two shows that we've just put out were around price, price transparency, and we just saw that CMS has issued clarifications around it and it's, uh, we're still going.

'cause they realize maybe the average American doesn't have any, any clue either. Yeah. Our, our, our perspective on things evolve as well. So back then I was saying, you know, it's, it's gotta be impossible for the consumer to understand their pricing. And by the way, I still believe that's true today. I think it's impossible, but I believe that's a problem that we need to solve.

It shouldn't be that hard for them to understand the pricing. It's, you know, when you get a bill with 55 line items, it, there has to be a way to quote for redoing something and, uh, it line things, but explanation. This is what's happening. This is what you're paying for, this is what's, we should be able to do that.

And some health systems have spent the time to do that, to make the, the readable bill that the person can understand. So I, I, you know, I still believe it's too complex, but I also believe it's a problem we can solve and should be able to solve. Yeah. And that's a fun part for me coming into healthcare because I have over 20 years of experience as a patient, uh, with chronic health issues, but I don't have, I.

20 years of experience that a lot of the distinguished CIOs and health leaders have, and they have expertise that is beyond my comprehension, but they may not have their perspective or I, uh, I said one of our guests recently put it, they might have access that a lot of average patients don't have. And so it is a great, uh, I'm sure great fun for you when I come to you with questions that

May seem seem very simple, but I I think they carry a lot of weight when you're not someone who's been inundated in industry knowledge for decades. Well, the the hardest thing is that you were a patient at the health system where I was ACIO. Yeah. That, that you'll say, Hey, consumer experience, this was my experience and I'll, I'll start saying things.

Well, you don't understand. That was really a medical group that was affiliated with us. And you don't care, which is, I don't, I don't, which, it's sort of the point. It's like that's, that's the complexity that we have to work through and yes, it, it's, it's a medical group, but at the end of the day, it's still affiliated with us.

It still has our name associated with it, and the experience should be a. St. Joe's experience across the entire network, and That's right. It's hard to pull off. I, you know, I sometimes it might sound like I'm, I'm saying to the CIOs, come on, let's, let's, we can do better. But I, I understand how hard it's, it's, it's hard.

Mm. Yeah. And, and it's equally difficult for, for building a customer, a consumer-centric experience when there is so many complex issues on the other side. And it's almost as if. We're requesting sympathy along with patronage. And, uh, it's, that's why we're doing what we're doing because we're not there yet.

But, uh, speaking of these, these kind of big issues, when we think of key moments in 2018, key moments in 2019 before the pandemic and the acceleration that went alongside that, are there things that . You look back on and say, oh, that, that was a big, I know that Coronavirus overshadows a lot, but before that, what were, what were some moments?

Well, you know, um. It's interesting because, you know, one of the things I do every year is I, I go to the JP Morgan conference and that really frames up my perspective of what happened over the past year. Now I cover a lot of it. I talk to a lot of people, but it's a vast industry. There's a lot going on at the JP Morgan conference.

You know, you get to hear. I don't know. Uh, 16, 18 different CEOs and CFOs stand up there and say, Hey, here's, here's how we perform financially. So you get a sort of a snapshot of how the industry's doing, but then you also get the, Hey, here's what we're doing strategically and here's how we're moving forward.

Um, and it's, it's interesting, you know, 2019 was the year of, uh, everybody was, was racing. There was a lot going on and it, you know, it really came out of 2018. 2018 was a. Um. It was a pheno, phenomenal year really for healthcare. There was, there was a signif, significant amount of reimbursement came from the Affordable Care Act that came more reimbursement.

In fact, that was one of the quotes from the JP Morgan conference that, uh, and I believe it was the CFO for, uh, Intermountain said this will be 2018, will be known as the high watermark for reimbursement, uh, for healthcare. And, uh, I don't know if that was the case or not, but that's what he was saying. And he wasn't the only one saying it.

Um. There was a, there was a couple themes in 2019. You know, there was, uh, uh, grow to Greatness was kind of one of those themes in 2019. 'cause again, we didn't have a pandemic. We were sort of looking at, you know, things were gonna continue as normal and you had significant acquisitions that year and everyone was talking about mergers and, you know, are we gonna end up with five large health systems in the country?

Like we've ended up with four main payers in, in, in the, uh, in the country. And so there's this sort of grow to greatness, uh, mentality. Um, that year though, I'll, I'll, I'll be honest with you, I, I really focused in, I, I, I learned. How different it is. And I, I knew this because I, I operated in Southern California market, but when, um, Bernard Tyson got on stage and started talking about their telehealth and that 65% of their visits to Kaiser were telehealth visits and it was over a million visits, uh, that was sort of a, that was sort of an interesting aha moment for me that there, there's a different way to deliver care, but it's tied to the financial model.

And Kaiser's able to do it 'cause of the payer, the provider, it's a different model. But everywhere else, telehealth was struggling and it was struggling because the, the financial model didn't match. Well that changed in the pandemic. I'm sure we'll talk about that a little bit. Uh, the other thing is, you know, the healthcare as a consumer was a big topic and has been a big topic for the last two years and, and continues to be a, a big topic.

When will the healthcare become a consumer is, is a whole nother question and sort of, I. Way of thinking, but health systems are trying to become more consumer centric and trying to make ways for people to experience care in a better way. Less wait time, uh, more convenience, more access, and uh, and all the things that that entails.

And maybe even access to services that they normally wouldn't have access to. Uh, you know, behavioral health, nutrition and those kind of things. So, uh, there's this focus on the healthcare consumer. That, that is sort of permeating the whole industry as well. Uh, I will say that, uh, the thing that hasn't changed in healthcare is, uh, the margins aren't that great.

I know it's hard to believe they, you know, trillions of dollars going into healthcare, but the hospitals themselves operate on, I don't know, it's on good years, 3% to 12% margins, depending on the, uh, brand and name of the, uh. Organization and the specialties that they have. Um, on bad years, it's negative margins.

And so there's always this, uh, do more with less that's been there for a fair amount of time. And, um. You know, I, it, it, it, it, it just seems like that was the, that was the theme in 20 18, 19 was establish market essentiality, get bigger, get to scale. Uh, and there's this belief that if we get to scale, we're going to be able to do things that other health systems aren't going to be able to do.

And we're gonna be able to weather the storms because we have scale. And to a certain extent, some of that did play out during the pandemic. So those, those were some of the. Some of the big, big themes, I guess in 2018 and 2019. , uh, does that translate into the work that you were doing at this, this week in health?

It, did you try and expand bigger, better, greater, what were some of the changes that you took on with the format of the show during that same timeframe? Yeah. Well, actually what couple things happened that second year? The first year I. When we brought people on, we, we did sort of a Newsday show with every CIOI brought on.

They, they had two, they brought two stories, or they brought a story, I brought a story. That's what we talked about. And then I'd end the show with like a couple questions around, Hey, what are you doing at your health system? Uh, you know, what are you doing with regard to data interoperability? What do you, so it was, it was a lot less of an interview show and a little bit more of a back and forth on the news show, uh, going into the second year.

Some of the feedback I got from CIOs were, uh, you know, it's, it's really hard. I don't have the time to prepare for the show like that. Um, and they, they found it to be easier to do a, an interview show. And so that's, that's really what we did is we, we moved to, uh, a show called Influence where we just interview them and we, uh, spend a little spend, uh, more time with them.

You mentioned this earlier, the shows in the first year are shorter. Uh, we did a survey of people and we've, we've done that survey every year. Now. We'll probably do it, well, we'll definitely do it every year. We might do it a little more often, but the, uh, the feedback was interesting. One, one of the, one of the people said something that was really, really resonated with me, and then when I followed up with other people, they agreed with it.

And that was, um, you know, you might as well do a longer show. Because when you get Ed Marks or when you get Rod Hockman or you get Darren Dwe on the show, uh, don't limit yourself to 20 minutes. 'cause I'm gonna listen to that show. I may not listen to all your shows, but when I listen to that show and you got them on the line, I.

I talk to them as long as you can. I wanna, I want to, I want to glean their wisdom. Um, so they were saying to me, look, uh, I'm okay with a 45 minute show. I'm okay with a 50 minute show. Uh, if you are, you know, if it's interesting and you're talking to somebody that I'm interested to talk to. So we went to a little longer show.

And then the other thing is I realized because we did that, we lost our focus on, on the news and the issues of the day. And so we launched Newsday about halfway through that, that year. And, you know, Newsday has become, uh, we, we still do Newsday. We do it a little different this year, but we do the Today Show as well.

And that's just an effort to keep people current. And that's the short show. That's the one that's the, today, now is six minutes long, seven minutes long, and you get a news story every day of the week. And my commentary on that story, so that's, that's the short show that people can stay current. Um, and then we turned the Newsday Show.

This 2020 this year, and I'm really, or 2021. I'm really enjoying this. 21. Yeah. 2021. I'm really enjoying this. We turned the Newsday show now into the, uh, a conversation with recurring guests. And so we have, uh, a, a handful of doctors that have been on and they're gonna keep coming on. Uh, sushi comes on every six weeks or so.

Drex to Ford is on every six weeks or so. Ann Weiler, former CEO for a, uh, health tech startup comes on and we have some great conversations as well. So, um, yeah, I'm really enjoying, you know, discussing the news again with, uh. Industry insider. So yeah, that's one of the things. I think the other thing, and we'll have to actually, you and I are gonna have to talk about this.

We did conferences in a big way in 20, uh, 2019. You know, we went to, um, we went to HIMSS and did about 12 interviews. I. We went to the Health Catalyst conference, talked to Dan Burton, the CEO. We've talked to Halamka, who was doing a keynote there. We talked to Rob Dhe, who's on their board, uh, Dale Sanders, who was working for them at the time.

We went to the Health 2.0 conference. I. Met up with Don Rucker. Uh, Michael Peffer was there as well. Ji Mayo from Texas Health Resources was there. So we had some great conversations there. And then went down to the health conference and talked to all the startups and, you know, talked to Olive ai founder Sean Lane.

We talked to Ginger, we talked to Pacific, uh, Pacific Dental Founder, and he was talking about how . You know, dental and, and health are coming together and they were implementing, uh, the Epic EHR across their entire, uh, platform. So we had some great conversations there. And then I, I think one of the most pathetic things I've ever done, I went to the Chime conference and quite frankly, I just sat at a table outside the door of the main conference room and just let people know, Hey, I'm doing interviews whenever you get a chance to sit down now.

We did a lot of interviews. But there was an awful lot of time of me just sitting there , and I was like, I don't know if I'll ever do that again. But it was worth it because we had some, again, I, Joel Vanko stopped by and, uh, James Brady stopped by. Mark. Amy stopped by, uh, Chaney. Cordero stopped by Darren Dork and others.

Uh. Uh, Cletus Earl stopped by John Kravitz. So we, we had some phenomenal conversations, but it was, uh, uh, that was, that was a weird moment for me just sitting at a table waiting for people to show up to, to do interviews and everyone walking by going, Hey, what are you doing ? So anyway, so yeah, we did conferences in a big way that year that, that was one of the things that I guess we'll have to determine if we're gonna do conferences in a big way going forward.

That has been a conversation, not only on our show, but it seems in the larger healthcare space is are we going to be able to return to conferences and do we want to, the way that they've been before? I mean this, this conversation has happened time and time again, right? That the pandemic has disrupted the way that.

We have typically done things, whether it's work from home, whether it's remote conferences and you know, remote care. And the question being, how much value is there in that return to the brick and mortar face-to-face interaction? And how much can we glean and keep around from these digital and remote initiatives that have come out of it?

And I guess that's kind of the natural Next question, we've talked about 2018 and 2019. So the year that shall not be named 2020, uh. Tragic in so many ways, and yet for healthcare, it seemed like it shocked the system in a way that it might've needed. Do you wanna talk a bit about what 2020 really catalyzed in healthcare?

Yeah. I mean, the silver lining and everyone talks about it, it's, it's, you know, one of the questions I ask people now on a regular basis is, what's the lasting impact of the pandemic on health IT or your health system? And they, they will invariably talk about the, the rise of telehealth. They'll talk about the, uh, work from home and the, uh, recognizing what's possible.

They, they did things this past year. We did things as an industry this past year that people didn't think were possible, and, and so they, it sort of opened up our minds to what we could do digital transformation. Uh, you know, chatbots and, uh, remote consults and you, you name it. We did, we did amazing things from a technology standpoint this year, and we learned what we can do with focus.

And that was, uh, you know, that's probably the, the, if, if we talk about the lasting impact, it will be conversations a year from now where people go, you know what? I know this is gonna happen. We're gonna, we're gonna fall back into some of our old habits, but a year from now, someone's gonna stand up in a meeting and go, I wanna move as fast as we did during Covid, during the pandemic.

And, and I hope somebody who's listening to this show raises their hands and say, I know exactly what we need to do. We need to focus. Bill and guests talked about this over and over again. What enabled us to move this quickly, it was a clear focus on the safety of our communities, the safety of our clinicians and, and the safety of our, our, our patients.

And we, we rallied, we rallied very quickly around that singular focus. We put all the extraneous stuff to the side and said, these are the seven, these are the 10, these are the 15 projects that we are gonna focus on for the next. Seven weeks, 10 weeks, 12 weeks. If we could just do that twice a year, we would make far more progress than we do with 150 projects on our plate.

And so that's, that's one of the things I think is going to be the, the, uh, coming out of this is gonna be the legacy of the, of the pandemic. We, we learned a lot of things. Uh, it also exposed a lot of gaps to be honest. Public infrastructure and the way we interact with community. Early on in the pandemic, we did an awful lot of shaming people for, uh, you know, doing things that are normal behavior.

Not in a pandemic, but instead of trying to win people over, we, we, we just, we clubbed them over the head with, do you not understand that this is a pandemic, you shouldn't be doing these things. And it, it got very political and I, you know, to the extent that we could be, uh, you know, a, a conduit to make, to, to move past that, we tried to do that and have the conversations.

In a non-political way. I had, I had David Zema on during the Covid series, and one of the things we decided to do was I was gonna play the skeptic and he was gonna play my, my, uh, primary care physicians and I was just gonna ask him questions, you know, you know, this is happening in New York, but it's not happening in my community.

Should I even care about this fire? You know, we just had the conversation and hopefully, you know, just had a dialogue that. You know, the, the, the conversation out there of, of what people could do, um, you know, you, one of the things that happened in 2021 for us, our, our numbers went through the roof. Uh, in 2021, we did, uh, almost 230,000 downloads of the podcast alone.

The videos, uh, we're getting about, uh, 2000 every 30 days, 2000 views every 30 days. Um, so it went through the roof and I think what happened for us is we became the conference, right? You couldn't go to a conference. And if you wanted to hear from Don Rucker, if you wanted to hear from, um, I, I don't know, Lee Milligan, if you wanted to hear from, um, just any, any number of these of great leaders, Sam Banerjee.

Uh, David Chow. I mean, gosh, hey, you know what? Our pictures got a lot smaller. I need, I need my glasses on and whatnot. But we, we had, we became the conference, we get, uh, I, I had a number of people say to me, Hey, thanks for doing the show. Uh, I learned what that health system was doing that helped us to really, you know, think through this or I got a bunch of emails during the, while doing the covid series specifically, but I still get 'em today of, Hey, do you know a health systems that's doing this?

I make connections all the time because I'm talking to these people and they may not have listened to that episode, I'll say, yeah, we talked about that on the show. Uh, you know, these two health systems are doing that. You might wanna reach out to them. We highlighted the mass vaccination events that were done, uh, really effectively at, at University of Colorado Health and at Atrium, uh, which were two organizations that did a phenomenal job.

The uc Health Document. Uh, I was so to be able to. Get that out there. So I think we became the conference and I hope we still become the conference because at the end of the day I had, you know, seven, 800 people that I was responsible for keeping current. And I don't know, I sent maybe 50 of 'em to a conference every year.

And so, uh, for the rest of them, this would've been a great outlet to hear from these industry leaders. As if they were sitting there having a keynote, and so I answered.

Oh, it was so long ago, bill. I, I'm not sure I remember. Uh, this, the question. This, this is my day. I do a show and then I get critiqued every day. Huh? Anyway. No, no. Necessary. I have the power of the editing button. Don't worry. Uh, yes. 2020. That was the question in, in what really? What was catalyzed during that time, and I think you addressed that, that you saw focus, that there was a pressure almost, there was an external pressure.

Far greater. There's a bit of insulation in healthcare now where the provider and, and the health system is, is set back a bit from customer dema, customer demand. Right. I mean, that's why we struggle to be patient-centric is there, there isn't that feel of supply and demand that might drive other industries and.

Perhaps this has been a, a catalyst for us to, to recognize that and as you talk about conferences and what's next? Uh, yes. I would love if people kept tuning into us and saw, uh, this as that same resource. And we won't tilt our hand on what's going on behind the scenes. But who knows? Let's start Rumors on our own show changing things.

No, you. Um, because you've asked me this question, we've talked about this, it's like, are you gonna run out things to talk about? Because it seems like we're talking about the same things, but there is nuance to what we're talking about. Uh, you know, the cybersecurity, we used to talk about cybersecurity and the, oh, let's not lose any records.

That would be a problem. And you know, you get the fine and you have to send out the, uh, you know, the identity protection paperwork to everyone that you lost their record. And those kind in should ransomware, should. Was a big, you know, conversation 2019. It got a little more serious, uh, late 2020, early 2021.

It got really serious. It got, they can shut down your hospital serious. You can lose all the medical images that you've ever done serious. And for the first time at the JP Morgan conference. At least a half dozen or more CEOs, CEOs got up and said, cybersecurity is one of our greatest concerns right now, and it's an area of of focus.

And so it changes, you know, it changes the lens, it changes the conversation. And now we're talking about, you know, what does this, uh, chief information security officer look like in 2021 when the CEO wants to talk to them on an ongoing and involved in business decision. Moving forward. And you know, I think that, that, that's one indication, 21st Century cures.

Back when we talked to Anish for the first time, way back when, was sort of like, yeah, it, it was passed. No one really knows what it's gonna be. This is generally the direction we're gonna go. We, we, we need to make sure that the, the medical record gets freed up. It needs to get in the hands of the consumer.

It needs to be accessible by the innovation community so that we can make some progress. Those kind of things. We need to sort of free it from the, the hands of, uh, those that are unwilling to share it. And so we knew in essence what it was gonna be the next year, 2019. We, in 2020, we, we saw, uh, really bipartisan support behind it of, of people.

Uh, the, the, the best was at himss. Where you had four administrations on the stage with Sima Verma, essentially affirming the direction of 21st Century cures and the sharing of information. And then we had the, the rules around information blocking, which just went into effect about a week and a half ago.

And so the conversation went from, Hey, we don't really know what this is. We don't really have to do much about it. Oh my gosh, what does this mean? I mean, there's now like a whole mechanism in place that if I write an app that requests information from my health system on my medical record and they don't provide it, I, I mean, I should just put a button there that says, tell CMS and they hit that button and it transmits the CMS and says, Hey.

They're, they're participating in information blocking. They're not providing the, the record. It's more sophisticated than that. I get it. I've reported on it several times, but, um, but I think this is the year that we start to see really these, uh, innovators make, uh, progress on top of that regulation for the first time.

And so.

We talk about big tech and we talk about these new entrants into the market. They're getting more sophisticated, um, and, and they're really finding their swim lanes. Amazon has found its swim lane and they're going down this Amazon care model because they're gonna build something for their employees first.

If they do it and they do it effectively, if they do it and do it effectively, they will expand it and they will offer as a outside of Amazon. But if they do, it's okay. May not expand. But they're finding their swim lane. They're like, Hey, we, we, we're good here. They're also good in supply chain, right? They can get stuff anywhere in the world.

Very quickly. They're good at, um, you know, making sure that, uh, resources are where they need to get to when they get there. So they're finding their swim lane. Microsoft, the Arms dealer is finding their swim lane. They are acquiring Nuance. They have a new set of tools that they're gonna sell into healthcare, and they're gonna continue to, uh, morph and create more tools.

Right. So it's ai, it's machine learning, it's different things. They're, uh, Google understand they're information. And that's what they're doing. They're trying to make sense of the medical record. And so they've partnered with several health systems. Uh, the most, uh, notable is Ascension in their a hundred hospitals, and they're bringing the medical record in and they're creating an overlay for the clinicians on the clinician side.

But they will also be creating an overlay for the patient side that will, uh, likely act as a personal health record or a patient portal of sorts, uh, for them. And then Apple is a consumer company. And actually probably one of the slower moving of, of those, of those three that we talked about, they're very methodical.

They're really about selling devices and they wanna increase the utility of their devices. And so when you look at it, they are, they still have the Apple medical record and probably have a significant amount of data in that medical record. But, uh, and. Some FDA approved, uh, monitoring that's going on there, but they're, they, they move slow.

To the extent that they can increase the value of the devices that they're selling, that's what they're gonna do. They're never really going to be a healthcare company, per se. Uh, e even though. That's the way they talk from the executive level. Uh, I I, I'm not seeing it. I'm not seeing it today. It would be, uh, but it will be some sort of device.

They're gonna sell some sort of device and they're gonna be the mechanism. So the, the conversation is moving forward. It's not moving at the pace, maybe that we want it to move, but, uh, but it's, but it's moving forward for sure. Right. Well, I think you covered what, where we're going in 2021, that, that gets us from 2018 when this launched to, to where we're at now.

And those conversations, big tech, digital acceleration, uh, the role of the CIO, where it's going, uh, all of that. Well, uh, not, not a spoiler, but an insight for our, for our listeners, if, if you're a reader. There's some great, uh, featured content coming out on our site around those exact topics in the coming months.

So, uh, hopefully we can pull together our conversations around those exact, uh, conversations on our show and put them all in one place for you. So, so Tess, what are you, what are you gonna be doing in 2021? ? What, what am I going to be doing? I'm not sure. I mean, this week in health, it, you, you've written your first article.

You have your first article out there, you're.

Yeah, so I think that we had a conversation, our first conversation when we were writing our first, what we're doing here, uh, over a year ago, bill, when you and I met, we, we realized that this week in health, it serves as a resource, right? We saw that during C-O-V-I-D, that it's a resource for individuals that are going through something at their health system, and they want to see what other health systems are going through.

Uh, covid again, a great . Example of that. And it's also true with cybersecurity and these new regulations getting rolled out from the White House and Capitol Hill. And it's important for, I think, that collaboration to exist because it helps us refine focus. And what we realized, uh, in the last few months is that a great swath of those people who can use this as a resource are a lot of.

Uh, people who have existed in the IT space or have gone directly from university to, uh, get a master's in health administration, public health, anything that they're gonna end up in these very roles and they're going right now and learning in college. And guess what? We are a, uh, perfectly free and, uh, extreme resource for all of those conversations from health leaders.

And so a big initiative that we have upcoming is, uh, making sure that we are. Informing not only health leaders, but as our mission states, the next generation of health leaders. And so we have a big push coming to make sure that these conversations that we're happening now are very involved with. Up and coming leaders so that they will have these priorities and these values that we are discussing about, you know, being patron, uh, patient-centric about being fast-paced, and agile.

All those things. We wanna instill those in the next generation. So that's a big push for us among, uh, all the other hats that I wear. That is what you can expect consuming me for probably the next six months.

Uh, the mission. We, we talk about the mission a lot actually. It's pretty, pretty interesting. As if it's a mission statement. , because, because it's a mission statement as you keep reminding me. It's a mission statement. Uh, but it's, it should guide every aspect of your organization. But I could go on my marketing soapbox and how it influences, uh, healthcare for much longer.

That's a different show. I think . Yeah, it's, you know, it's interesting, somebody, there's this thing that goes on in healthcare where people are like. You know, vendors shouldn't make money. Uh, no one should make money in healthcare except for people providing care. And, um, you know, right or wrong, I, I, I don't, I don't really subscribe to that.

If you're adding value, uh, there should be money. But, you know, the, the, the, and so somebody said to me, you know, you, you, I can't believe you're making money from this. And I'm like, well, first of all, we didn't take a sponsor until like episode 300, um, or at least 200. You know, the first two years we had no, no sponsors whatsoever, so we just did it and, uh, incurred all the costs associated with it, and then six.

Um, no, nobody's retiring on this. This is, uh, pretty much we're doing it for the mission. We really are. And to be honest with you, it, this thing is fueled by emails. It's fueled by, um, comments on social media posts, and we're sharing 'em with each other all the time. Like, Hey, this is really cool. This, this, uh, you know, this student just reached out.

We had a professor reach out to us, say, Hey, I use your materials in our class. We had a student reach out and say, my professor assigned your, uh, you know, a couple of your interviews in, in, in our class. They're phenomenal. I really appreciate it. We've had, you know, emails from people saying, you know, thanks for sharing that, uh, sharing those stories, sharing that, you know, doing this.

And they just, we, we were fueled by that. So feel free to send us notes. We love it. It.

Yeah. What I have to explain to people, oh wait, go ahead. No, no, no. Go ahead. I was, I was gonna wrap us up. I, you know, so I was gonna wrap us up after my charming anecdote. I will chop this out. Uh, what I was gonna say, I. When I am explaining to people what I do for a living, it's kind of a complicated thing that we have going on here, but when I'm talking to just my friends in my normal life, I'm able to say, have you ever walked in to your doctor's appointment and gotten handed a clipboard with 10 sheets of paper?

Have you ever sat in a waiting room for two hours? Have you ever sat on hold with your doctor? I'm working to make sure that you never have to do that again. And apparently that means something to them. When I say that I, uh, do marketing for a podcast and a media site, it, it's a little less impactful, but when you remember what you're doing it for, then it really helps hone it in.

Yep. And um, yeah, and it is.

One of the legacies of the pandemic is we got rid of most of the clipboards in our health system. And I'm like, yes, test can tell people this health system she used to go to got rid of most of the clipboards. So, um, most of them, mo, I, I, I'm not sure he said all, so I'm gonna have to go back and listen to the transcript.

I'm pretty sure he did not say all. So, um, it we're making progress. Making progress. That's.

That's all 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, Spotify, Stitcher, and whatever else comes out next, we'll figure out a way to get on it.

Uh, we wanna thank our channel sponsors once again, who are investing in our mission to develop the next generation of health leaders, VMware Hillrom, Starbridge Advisors, McAfee and Aruba Networks. Thanks for listening.

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