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April 21, 2020: Welcome back to another Tuesday Newsday! This week we are covering a few stories reflecting on the current pandemic and these include perspectives from some leading CIOs in the space with insight that you are not going to want to miss. The first piece we we look at was published by AHIP and features a study by Wakely around the potential financial costs of the COVID-19 crisis. These range from around $50 billion to $550 billion, so the range is still wide and one might say the findings are not very clear as of yet. Then we turn to an article on the problems many are experiencing with their health insurance currently. At this point many of the population have lost their coverage and this shows no signs of slowing down; this is a crisis on top of a crisis and obviously could not come at a worse time for those affected. The last article we look at comes from Beckers and focusses on perspectives from several top health systems CIOs, where they were asked to share lessons and advice borne from this time of crisis. A number of these CIOs have been guests on the show and Bill shares a bunch of helpful insight that is featured in the article, so make sure to stay tuned for that part of the episode! 

Key Points From This Episode:

  • The predicted costs of COVID-19 to the healthcare sector; a study by Wakely.
  • Intersecting issues of the pandemic and health insurance — who will lose their coverage?
  • Anger over the way financial aid is being dispersed to hospital during the crisis.
  • How these financial concerns affect everyone in the healthcare technology space. 
  • The message that health leaders should be taking from this pandemic: strategies come from the business!
  • Beckers' survey on top health CIOs and their priorities and advice amid the crisis. 
  • The integration of IT with the rest of a healthcare organization. 
  • Great responses from carriers for the necessary increases in bandwidth for healthcare.
  • The inspiring and creative uses of technology we have seen across the board.
  • Areas in healthcare that should receive a renewed emphasis; efficiency, interoperability and more.
  • Amazing feats in communication and other success stories from this crisis.
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.

 Welcome to this Weekend Health it. It's Tuesday News Day, where we take a look at the news, which will impact health. It. . Today we're gonna take a look at, well, we're gonna take a look at the financials of healthcare real quick because it's important. And then we're gonna take a look at, uh, what six CIOs said were their top priorities and key advice during c Ovid 19.

These are six CIOs that we did not talk to on the show, so I thought I'd take a look at what they were saying, uh, online in the news. My name is Bill Russell Healthcare, CIO coach, creator of this week in health. It a set of podcast videos and collaboration events dedicated to developing the next generation of health leaders.

Are you ready for this? We are going to do something a little different next week for this show. We are going to go, . Live at noon Eastern 9:00 AM Pacific. We will be live on our YouTube channel with myself Drex to Ford S Shade, and David Munz with Starbridge Advisors to discuss the new normal for health it, uh, with you supplying the questions with a live chat during the whole thing.

I'm so excited to do this and I hope you will join us. Mark your calendar. Noon Eastern 9:00 AM Pacific Time on April 28th, we're gonna do our Newsday show. . Live. There you go. This episode and every episode since we started the C Ovid 19 series has been sponsored by Sirius Healthcare. Uh, they have really reached out to me and, uh, to see how we might partner during this time, and that is how we've been able to support producing so many daily shows over the last couple of weeks.

Special thanks to Sirius for supporting the show's efforts during the crisis. It's, uh, it's Tuesday Newsday, and here's what we have in terms of news. We have a couple stories. Uh, . A hip. C Ovid 19 study, uh, could cost healthcare $556 billion over two years, uh, intersecting US epidemics, uh, C Ovid 19 and lack of health insurance.

Uh, fewer erupts billions going to hospitals based on Medicare billings, not c Ovid. 19. These are three stores. And then the last one I already discussed that, uh, we're gonna take a look at is Becker's story. Uh, which has, uh, some, uh, quotes from some different, uh, CIOs. Want to take a look at those. So American Health Insurance Plans ahip, uh, released a study that, uh, COVID Ovid 19 could cost Healthcare $556 billion over two years.

And let me read some of this for you to get more complete picture of what C Ovid 19 costs could be. AHIP retained weekly consulting group to explore the potential cost implications of Covid 19 testing. And treatment to US health insurance providers for 2020 and 2021. Wakeley estimated that the cost to the healthcare systems for COVID 19 could range.

From 56 billion to $556 billion over the next two years. So I love the, uh, . I love when they do that with the headline. It could cost 556 billion. Of course, the range they give is 56 to 556, which is a wildly huge range by the way. And it shows some of the challenges with doing these studies right in the midst of the, uh, crisis.

Uh, the risk and impact of Covid 19 are unprecedented, and we are learning more about its true impacts every day. Actual outcomes will differ depending on the things like number of Americans who become infected but are asymptomatic. The impact of interventions such as social distancing and the availability of testing hospital costs could exceed wakely's estimates if average intensive care stays are longer.

More expensive or require more services than estimated in these models. In other words, , that's, this is, I'm sorry, I, I'm highlighting this because it is, it is a very real thing. There will be significant costs, but I'm reading this study. This is, this is, uh, having been a consultant for many years, I'm reading this and sort of, sort of giggling because it's, it's the quintessential, you asked me to do a study.

I did a study, but hey, the range is really broad. And it could be even broader if some things change. So, uh, but Wakely's findings are based on the data and information available on March 28th, which gives you an indication of why they're struggling. As we know, the numbers have been changing pretty, uh, dramatically through the course of this pandemic.

As the C Ovid 19 national emergency continues to evolve, AHIP and Wakeley will revisit these findings and provide updates. As needed. The report considers the impact of Covid 19 to commercial Medicare Advantage and Medicaid managed care plans, assuming a 20% infection rate among the study population.

The report estimates that more than 50 million Americans will become infected. With at least 5.5 million requiring hospitalization of which 1.3 million will require intensive care for each person admitted into intensive care costs on average could exceed $30,000. Uh, please see the full report and they have a link to the full report.

Uh, they also go on to talk about, uh, out-of-pocket costs. So what about out-of-pocket costs? The report also considers the potential out-of-pocket costs. Consumers could experience. For C Ovid 19 Care WAKELY estimates enrolling cost sharing would on average be approximately 14 to 18% of an of annual allowed costs on average, across lines of business model, and would range from 10 billion to 78 billion.

This figure does not take into account, uh, announcements made by health insurance providers. . That they're waiving out of pocket costs for C Ovid 19, which is a pretty significant number of them that have waived those costs, by the way. So, um, it'd be interesting to see how that comes out. So that's the first of a financial, um, picture that I'm trying to paint here.

So here's the next one. Intersecting us, uh, US epidemics, uh, covid to 19 and lack of health insurance. From the Annals of Internal Medicine, April 7th article, uh, a report published, uh, in the Annals of Internal Medicine estimates that more than 7 million Americans could lose their employer-sponsored health insurance during the C Ovid 19 pandemic.

More than 1.5 million Americans have already lost their health insurance, and 5.7 million are projected to lose their coverage by the end of June. All right, so that's the second thing, right? So we have significant cost to the health systems. We have a whole bunch of Americans, . Uh, getting closer to 20% unemployment that are gonna be without health, health insurance, uh, employer sponsored health insurance.

And finally, for those who are saying, well, you know, the government is going to throw money at health systems 'cause they wouldn't, couldn't possibly not support them during this time. And they did. Right? So there was $30 billion in the, uh, original CARES Act. And, uh, here's what happened. Fear erupts billions going to hospitals based on Medicare billings, not c Ovid 19.

So, uh, they quote an executive, well, they have this whole thing about an executive in, uh, Florida. I. Um, and it says, executives at beleaguered systems are blasting the government's decision to take a one size fits all approach to distributing the first $30 billion in emergency grants. HHS confirmed Friday that it would give hospitals and doctors money according to their historical share of revenue from Medicare programs for seniors, not according to their coronavirus burden.

This method is woefully insufficient to address the financial challenges facing hospitals. At this time, especially those located in hotspot areas such as New York City region. Uh, Kenneth Rakey, CEO of the Greater New York Hospital Association said in a memo to association members states such as Minnesota, Nebraska, Montana, which I.

The pandemic has touched relatively lightly, are getting more than 300,000 per reported C Ovid 19 case in the 30 $30 billion according to the Kaiser Health News. On the other hand, New York, the worst hit state would receive only about $12,000 per case. Florida is getting $132,000 per case. Uh, Kaiser Health News relied on the state.

Breakdown provided to the House Ways and Means Committee by HHS, along with the covid 19 cases tabulated by the New York Times. Alright, so lot of stuff around financials. Why am I talking about financials? This is called This Week In Health. It. Well, you know what the reality is? The financial picture has changed for every health system.

Uh, now more than ever. It is important for CIOs and other IT leaders to understand the impact. and start to consider the ramifications. We've just been asked to, to summit this huge mountain and, and, uh, you know, in response to the coronavirus, right? So we stood up telehealth, we stood up, work from home.

We've done a lot of, uh, just amazing things and we should stop at the top of that mountain, put our arms around each other. Take it. Well, six feet apart, take some pictures and enjoy the, the view. Um, but we're gonna have to come down from that summit. And that's what I've started to talk about, uh, starting last week.

And, um, you know, it's, it's, we need to try to figure out the new normal for each health system, right? So we're gonna be returning, you know, if I use that mountain analogy, we started from a base camp. We went to the top of the mountain. But we're gonna be returning to a different base camp than the one we started off on.

And it's trying to figure out, uh, what the new normal is for your health system. What base camp are you gonna be returning to? Most health systems will be, uh, you, they, they're generally conservative organizations, uh, coming out of this, but there are gonna be others that are gonna have the opportunity to be, be, to be aggressive, right?

Uh, it is widely considered to be, uh, truth. That large health systems will, will weather this storm better than smaller health systems? And I'm not sure that's really true. Large health systems have more resources. That is absolutely true. And some, uh, some smaller systems don't have enough resources and they're gonna really struggle.

Um, but, you know, large systems also have more liabilities. And the operative word there is the word more. They're bigger and less nimble. Uh, I was with a company that went through chapter 11 and one of the mantras. I got really tired of hearing, uh, coming out of this was, uh, cash is king. Well, in coming out of this, access to capital is gonna be the king coming out of this crisis.

Strong business leaders will understand that this crisis opened up a rare opportunity in the market. Uh, you know, you get to place Betts coming out of this. If you have the capital to do it. And while a bunch of emphasis over the past couple of years has been on internal efficiency, I believe that m and a activity and consolidation is gonna be the, uh, really the, the, the new order of the day coming out of this, um, I.

You know, so what is the message to health? IT strategies come from the business, the business environment changed dramatically. Understand the business environment and its impact on your health IT strategy. We're coming down to a different Basecamp. Start to evaluate how your system is thinking about, uh, the new norm and the new, uh, environment that we are walking into.

So just something to consider as we come out of this. All right. So, you know, not everybody came on this show for per se. Some of 'em actually, uh, didn't have time. And so what they did is they responded to some emails. A lot of, a lot of these articles that get written. Uh, I as A-C-I-O-I used to receive some of these requests.

They'd say, Hey, we're, we're gonna do an article. Uh, can you answer these three questions? And it's a lot easier to sit down at, at your, uh, at your desk and just answer these three questions and you send them back and voila, you have an article. And I think that's the case here. I'd be surprised if it wasn't the case here.

Um, this is a, uh, Becker's story and it's called The Difference Makers. During This Surge, six CIOs on top Priorities and Key Advice Amid. C Ovid 19. So, uh, couple of people are quoted here. Uh, none of 'em have been on the show. No. Uh, uh, let's see. No, actually two of 'em have been on the show, but not during the, uh, COVID crisis.

BJ Moore has been on the show, CIO of Providence, and, uh, Tom Barnett, CIO, for University of Rochester Medical Center, has been on the show. Uh, so I'm gonna touch on some of these. I, I think it's, uh, . I think they did a good job answering these questions. So, uh, three top priorities during c Ovid 19 enhancing.

So this is Jeffrey Sterman, CIO for Memorial Health Healthcare System in Hollywood, Florida. Uh, top three priorities enhancing and rapidly pushing out our existing telehealth capabilities. We've heard that over and over again, and that is true. Uh, helping to coordinate consistent and constant communication with our patients and consumers via any and all technology means.

That includes websites, texts, emails, bots, telephone, and even manually. Um, while also helping the facilities communication to our internal healthcare staff through video conferencing and all other traditional means. Uh, I love that. I think that has a lot of great insight in that. Uh, early on we were sort of looking at this, but I was hitting websites early on that were

Uh, way behind the curve. I mean, we should have had things on our website early on. We should have been redesigning them. This is gonna be something to consider as we come out of this. Is, do we have the ties between, uh, marketing and IT and, uh, even some, uh, some clinical information? Uh, do we have all those, those ties together so that we can, uh, produce the, the websites and the texts, uh, texts and emails that are gonna go out, um, and, uh, stand up the bots that we need?

Uh, a great observation by Jeffrey Sterman there. Uh, and then he had, uh, designing, automating, uh, designing automated screening, scheduling . And results notification process for our local, regional, and state, uh, representatives in testing of c Ovid 19. The, the thing I hope comes outta this, by the way, is we just stood up these things for c Ovid 19 that we have struggled to stand up for, I don't know, a decade.

I. You know, quite frankly, getting those test results back in a timely fashion, uh, to our patients. This should be something that we, uh, we had done a long time ago. So those are three of his top priorities. His, uh, key advice. We, we need to all remain extremely flexible in these uncertain times, and we are used to running projects across.

Our diverse settings, our IT teams are oftentimes helpful in coordinating and facilitating major initiatives, and we are certainly in the midst of major activities in dealing with Covid 19, and it can help to keep things controlled. Finally, we are all in this together. The thing I like about it, about these statements, the key advice statements.

Is it talks about the integration of it if your IT team is tightly integrated with the other parts of the organization. Uh, with marketing, with the leadership team, with the clinical side, uh, we're te generally tied in pretty well with the clinical side 'cause we're doing so many ER projects, but we need to be tied in with all aspects of the business and he really highlights this.

Uh, let's, uh, skip that one. Uh, BJ Moore, uh, we are starting to see BJ Moore, vice President, uh, E-V-P-C-I-O of Providence. We are starting to see the benefits of our progress that we have made, standardizing our systems and tools, moving to the cloud and simplifying the environment. Having most locations on the same instance of Epic, for example, has been critical in helping us drive rapid response.

To changing needs, having Office 360 fives and teams rolled out, uh, the majority of our caregivers have also made, made a big difference in our ability to maintain productivity. This together with improvements in network capacity and VPN are allowing us to enable work from home for a broad range of clinical users.

Um, I thought it was interesting. A couple of the CIOs came on and did talk about the fact that even though they may not have predicted the level of bandwidth they needed, the uh, the carriers really stepped up. In this case it was, it was a, a phone call or two, uh, expedited contracts and things were turned up in days that would normally take, uh, weeks or even months.

And, uh, you know, kudos to the, uh, to the carriers out there who, who recognized the situation that we were in. Uh, they prioritize the bandwidth to the, uh, uh, to the health systems, uh, during the crisis. Uh, you know, BJ really focuses in if, uh, you spend any time with him. You know, he is a big platforms guy, cloud platforms, uh, platform tools, uh, as well, I.

Uh, office 365 teams. We've seen teams used pretty effectively, uh, in this, uh, in, in this, uh, crisis as well. And, uh, not only, not only for managing projects and managing your, uh, your work from home teams, but also, uh, we've seen it for clinical rounding and some other things. People are being really creative with this.

Uh, I think teams is gonna be one of the big winners out of this. I think Microsoft is gonna be one of the big winners out of this. Um, if there are winners, I mean, clearly this is a pandemic. There are people, um, uh, there are people dying and those kind of things, but I, I think we are going to have new learnings out of this.

We are gonna be stronger out of this. And one of the, one of the things is that we are experimenting and learning how to use some of the tools that we've had in our arsenal for years. And, uh, we recognize the need for that in the crisis. And sometimes you only recognize it in a crisis and bring it to bear.

So, uh, some great stuff to, um. Uh, from bj his key advice, important to have strong leaders engaged across the board, driving very intense coordination. In, in this kind of situation, it is very easy to have many well-intentioned efforts at odds with each other, which can result in a waste of time and resources.

It's important to have well-functioning command and control structures to manage the response. Also, having to enable business processes and roles that are traditionally performed. At the office setting versus home has provided valuable insights for our device strategies, for example, using laptops instead of desktops, so forth.

Um, again, great insights. Appreciate, uh, BJ talking about those things. Uh, Lacey, uh, Williams Carlson, CIO, Bon Core Mercy Health outta Cincinnati. Our top three priorities to support clinical operations include rapid . Changes to our epic instances to build c Ovid 19 dashboards. And we've talked to a, a, a fair amount about that in the, uh, on the show.

And, um, yeah, a lot of great work has been done there. Uh, build, uh, let's see. That was, uh, . So build covid to 19 dashboards and registries. Build and configure repurposed inpatient care units and support changes in accessing records. Number two, deployment of technology supporting, uh, new approaches to care, such as workstations on wheels located for isolation rooms, um, and rapid expansion of virtual visits.

I'm not gonna touch on virtual visits. We've touched on that a couple of times, but the, uh, uh, you know, the. The organizations that have a single instance of the EHR, regardless of what that is, I'm not a proponent of one versus another, but if you have a single instance of your uh, EHR across your health system, I think you had a huge advantage going into this crisis.

And I think it's gonna be one of the things that gets evaluated if you are a system that is trying to do a multi EHR strategy. Um, and you had not, uh, progressed far enough along in terms of your ability to have those integrated and the data sharing, the ability to do screens across multiple things. Uh, across multiple instances, uh, I think you recognize the, the significant weakness of that strategy.

You either need to shore up your ability to do that, or you need to adopt a single EHR strategy across the board. Um, and then the other thing I think we saw is, uh, creative uses of technology. Um, you know, we saw, uh, cameras taking temperatures of people. We saw, uh, uh, iPads in rooms. We, uh, limited the number of

Uh, times that people had exposure to covid patients. Uh, a lot of really cool, uh, thoughts on that. So, uh, Lacey's key advice, the biggest need for technology, resources and budget to support caregivers is additional mobile devices and new configurations to support constant innovation and new use cases.

The partnership of clinical informatics. And it has never been more essential to assure we meet caregivers needs. I would like to commend many of our vendors who have stepped up to say, . Uh, what do you need and have partnered with us to get the equipment and assist us in building out solutions. Uh, Zafar Zafar, Zafar, Z-A-F-A-R, Zafar, Shari, uh, doctor, uh, senior Vice President, CIO, Seattle Children's.

My priorities include maintaining a stable and resilient remote working platform technology, the mental health of my employees, keeping clinicians, uh, clinical services supported so they can continue to take care of patients and pivoting. Key advice, uh, COVID 19 is going to have a long-term effect on how healthcare organizations look at their costs.

How they shift delivery of care away from the medical centers and how they pivot to virtual moving forward. Healthcare systems must reevaluate all aspects of how they deliver care. And make sustainable plans to put cost improvement programs into place throughout all clinical and nonclinical areas.

Healthcare systems should plan to reduce back office costs, including it, human resources and revenue cycle also. Uh, I think it's interesting. Um, that's one of the reasons I focus on those, those three financial stories. I think, uh, uh, Dr. Shari appropriately points out that, um, the, the new norm. Is going to be one where we put a renewed emphasis on efficiency, a renewed emphasis on interoperability, a renewed emphasis on financial management.

And, uh, cost reductions I think are gonna be, uh, par for the course. And then Tom Barnett, university of Rochester Medical Center. Uh, our top priorities tended to shift very quickly once C Ovid 19 took center stage. As a result, the team shifted priorities to those that immediately supported, uh, the health system, uh, including scaling up our ability to support work from home scenarios, expanding telemedicine, um.

Provide, uh, connected with their patients and focusing on our expenses, both operating in capital to assist the organization through this challenging time. I'm extremely proud of how great IT leadership team, uh, our, our great IT leadership team that is staying synchronized with our operational, uh, leadership.

The other thing I will point out, just from doing so many of these shows. Over the last 30, I think we've done 35, 36 of these shows and talking to different CIOs. Um, it's, it's amazing the things we've been able to stand up in the last, uh, in the last 60 days in terms of communication. We have, we, we've created this cadence, this rhythm of communication that I don't think we had.

Or at least we didn't have it as often. And a lot of times we ended up with, uh, miscommunication or gaps in our communication because we didn't have that stood up. And it'll be interesting to see if we can maintain . Those, uh, communication rhythms, those communication, uh, cycles or, or the cadence of communication, uh, uh, and the clarity that has has come out of this.

Now, I realize part of the clarity is because of the focus on C Ovid 19, but, uh, perhaps from this we will have experienced what focus feels like for the health system and we can, uh, take it forward with us. So, . I wanted to touch on that story. Some great, uh, some great wisdom, some great, uh, insights from those leaders.

That's all for this week. Special thanks to our sponsors, VMware Starbridge Advisors, Galen Healthcare Health lyrics, pro talent advisors. And serious healthcare for choosing to invest in developing the next generation of health leaders. This show is a production of this week in Health It. For more great content, check out our website this week, health.com, or our YouTube channel as well.

If you want to support the show, the best way to do that is share with the peers. Send an email or let them know however you do it, that you get value outta this show. And, uh, that will really help significantly. We're gonna be back again, uh, for more episodes through the entire remainder of this week. . And, uh, don't forget live next week.

In fact, I didn't give you the url. It's this week in health it.com/live. That's right. It's that simple. Or this week, health.com/live. They both go to the same place. Thanks for listening. That's all for now.

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