This Week Health

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August 25, 2020: Bill was wrong! About the CDC HHS stuff. He explores the rocky transition and why he’s glad he was wrong. You get cars from Uber, food, even a helicopter. Now they deliver drugs too. We can’t afford to lose billions in a crisis again. We have to focus on speed and agility. How fast can we launch new business models? How good are we at improving productivity? How fast are we developing new products? We also look at the startling UCSF hack ransomware story, REI going remote and selling its corporate headquarters and the scary Orwellian future of health passports. Big brother really is watching.

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 During the peak of Covid 19 in, in New York City, we were doing a thing called Field Reports, where I was interviewing as many CIOs, CTOs, uh, CISOs as I could around the industry. We were releasing shows five days a week, and I was interviewing one of the CIOs, and when we got done, he said, I've listened to a couple of these, these have been fantastic, but I, I don't have time to listen to all of 'em.

Is there any chance that when you hear something interesting, you can shoot me an email or can you shoot me an email with. Uh, a bunch of the interesting episodes that you've done so far, and that was the genesis for this idea of clip notes. And CliffNotes is an email that you receive. You sign up for this newsletter and you get a one paragraph summary of the show.

It'll give you, uh, just an understanding of what went on. We have key moments in bullet point format with timestamps, so you can go right to that part of the episode if you see something that's interesting. And we give you one to four video clips, short segments of the show that make it easy for you to, uh, share with your, with your staff, with your peers, with others.

It, it's a great way for you to stay current. Just get that email quickly, scan through what was talked about, who's on the show, what was talked about, what was important, and then you can determine am I gonna download that to my, to my iPhone or, or to my Android device for listening on the way home? And no, we designed it based on your input.

And, and, and we believe it's something that is really gonna help you to, to stay current, keep your team team current, and again, to really help to get these great interviews and conversations out into more hands. So you could sign up, it's really easy. Sign up one of two ways. Go to any episode page on our website this week,, and you can, uh, click the subscribe button in the top right.

Uh, or you can send a note to CliffNotes, C-L-I-P-N-O-T-E-S at this weekend, health, and it'll kick off an automated workflow now onto our show.

Welcome to this weekend Health it. It's Tuesday Newsday, where we look at the news, which will impact health it today I was wrong. Yep. I was wrong. About the C-D-C-H-H-S stuff and, uh, I can't wait to talk to you about it. In the second half of the show, I'm gonna talk to you about it. We're gonna take a deep look at that, why I was wrong, and why it is a really good thing that I was wrong.

My name is Bill Russell Healthcare, CIO, coach and creator of this week in Health. It I set a podcast videos and collaboration events dedicated to developing the next generation of health leaders. This episode and every episode since we started the Covid 19 series has been sponsored by Sirius Healthcare.

Now we're exiting this series, but Sirius has stepped up to be a weekly sponsor of the show through the end of the year. Special thanks to Sirius for supporting the show's efforts during the crisis and beyond. All right. Oh, one last thing. If you haven't signed up for, uh, three X Directs yet, uh, you're missing out.

Text Drex, DREX to 4 8 4 8 4 8 and receive three texts every week. With stories that'll help you to stay current. Uh, it helps me prepare for the show, and I think it'll help you to stay current. This is a service of Drex to Ford. He's a frequent contributor to the show and someone I'm looking forward to having on the show, uh, shortly to discuss the news.

All right. We started something a couple weeks ago and we've gotten good feedback, so we're gonna continue to do it. A little more structure around it than, than before. And that is, uh, we are gonna look at . Four main sites, and these are the four sites that I get a majority of my news from Modern Healthcare IT News, Becker's, and uh, healthcare Innovation Group, HC innovation

Those are probably the four places. I get a majority of my stories now. I get others from other places and we'll continue to do that. But this is like the quick headline view. And now remember, I'm not talking about healthcare specifically. I'm not a doctor and I'm not talking about politics in general.

There's a bunch of poli political stories in here. We try to focus in on healthcare it. If technology can solve the problem, I. That's a topic we wanna talk about. Alright, so, uh, we also talk about the business of healthcare and because there's a bunch of that here, because a bunch of organizations have, uh, announced their Q two earnings, right?

So the lead story in modern healthcare is Mayo Clinic's margin slides in Q two and volumes back to normal. I think that's the, that should be the lead volumes back to normal at Mayo. That is a very encouraging sign. So if we are seeing that kind of snapback, . Then that bode well for Q three Q four with a lot of health systems.

But with that being said, a Mayo slide is a little different than other people's slide. Their margins usually run at about nine 10% for this quarter. I didn't, again, I'm looking at the headlines. It doesn't tell me in the headline. I'm just remembering back to the JP Morgan conference. Somewhere between nine and 12% is where they run, and uh, they slid back to about 4%.

So they were still on the positive side of the ledger. , and that was a bad quarter. Second quarter was a bad quarter for healthcare. In fact, I think if I go down here further, yes. Here it's, so Sutter Health announced their earnings, uh, and their margins hit negative 11% amid the pandemic. And that just goes to the point of you really have to understand the business that you are in healthcare.

It is about supporting the business of healthcare and the outcomes of healthcare health within your community. And so we have to continue to, to expand our knowledge. If you are a technologist, we have to expand our knowledge into the business of healthcare and into the practice of healthcare. Uh, if you're a physician who happens to be brought into technology, then hopefully you're listening to this show to get more grounded in some of the technology.

As we get. We geek out from time to time and that helps you. Uh, but for those of you who are technologists, I wanna keep encouraging you. To understand the business, do you know what Case Mix Index is? Do you understand, uh, the competitors that are coming to your market? What does it mean? Do you know what a low asset strategy is going into your markets?

Do you understand what a platform is and how a platform is going to, uh, help your organization to operate as a more, uh, seamless entity as they interact with the various health providers within the community? So there's a lot of things that, that's the reason we talk about the business of healthcare.

'cause it's important to understand. All right, let's keep going down modern healthcare. Wow. Lot of political stories. Lot of financial stories. Uh, here's one that might be of interest to you. I'd, it's not overly interesting to me, uh, but I will share it with you because I know it probably will be Epic's $420 million Trade secrets, damages when gets slashed.

The reason this is not of interest is 'cause this happened back in 2000 early two thousands. Tata Consultancy Services lost this lawsuit. And the reason they lost this lawsuit, epic gave Tata back when Epic wasn't epic, right? They weren't the behemoth, they weren't the intergalactic world headquarters in Verona.

They were in Verona, but a little different back in the early two thousands, Tata was the consultancy services that provided support for, uh, Kaiser, which was the largest client for Epic. And they actually gave Tata consultancy, consultancy a full access to the source code. , and obviously there's safeguards and caveats around that, and Tata went way over the board, uh, overboard on that stuff.

They, uh, have emails showing their consultants sharing source code with people that shouldn't have had access to source code. They then went on to develop a competing product to Epic. So anyway, the, the initial award was not close to a billion dollars. That's been slashed to 420 million, which is considered to be more in line with the crime.

I don't know if it is or not. But what Tata did is bad, , bad and wrong. You gotta keep those. Even though you make an agreement in 2004 and you get to 2008, you're still under that agreement. So you gotta put the, the controls and the measures in place. All right. Florida hospitals lose billions due to pandemic measures.

This is something we're to come back to. I'm gonna look at a, uh, McKinsey article a little later in the show. And I'm gonna talk about agility and business agility. Uh, we have lost billions due to pandemic measures and those kind of things. But part of it is we are not agile as organizations. So anytime we have to make a major move, we have to spend a lot of money.

We have to exert a lot of energy and force. And, uh, once you put platforms in place, once you have agile as a, an operating model, you're able to to move a lot quicker. So that's, that's something. And then the other thing is, I'm reading too many of these stories. To be honest with you, we did lose billions.

That is true, but we also got billion, uh, no corresponding billions in Cares Act money now before everyone flips out and says that doesn't compensate for the full amount. I understand it doesn't compensate for the full amount, but we had a, okay, first quarter we had a horrible second quarter. We received a bunch of money to cover that.

Not all of it, but a bunch of it. But we also have endowments. We have . Other, uh, sources of income we go into third quarter and the thing bounces back to about 90% of our revenue. And if the Mayo thing is true, we're going into the third quarter with potentially almost a hundred percent of our revenue back.

I'm not sure we should be crying in our milk all that much. Let the hate mail begin. Anyway, that's just my personal opinion. I, I think we should have been able to bounce back from this just fine based on what we're looking at post pandemic. Now, I will have some other people on the show who can correct me a little later.

Let's see. Anything else here now? Not probably the last thing. So Uber enters RX at home delivery market. I think that's gonna be the new norm. Quite frankly, I think at-Home delivery of drugs, express Scripts has been doing it for years, as have others. . And I, while I think people enjoy getting outta the house and all that other stuff, going through the process of putting the prescription in, getting it over there, waiting, getting the phone call, come get it.

But that's something we could do without in our lives. And I think, uh, we will do without in our lives. I think we will have those prescriptions written at the doctor. They'll be submitted to somebody who's gonna deliver 'em to our house. It's gonna be more the norm. Let's see. Healthcare IT news. Less and less becoming a go-to site for me, mostly because, uh, so much advertising intermixed a lot of sponsored stories and those kind of things.

So it's getting harder for me to pick out which ones are, which many children respond better to therapists on telehealth screens than face-to-face. That's probably something that would interest me as ACIO I'd want to understand that more because there's people that are not excited about telehealth. Uh, so what, why did it work for children?

And, uh, how they reacted to therapists. That would be an article I'd probably wanna de delve a little deeper in, uh, health passports and distancing tools among c Ovid 19 Tech Climbing the Gartner Hype Cycle. This is the, uh, July release it looks like. Is that right? July release of the Gartner Hype Cycle.

Uh, I always keep an eye on the Gartner Hype Cycle. I think it's worth, uh, looking at, it gives me an idea of what I'm gonna be talking about. Pretty predominantly in two years, not just on this show, but if I were the CIO, I'd be keeping an eye on that. It, it's also gonna gimme an indication of what people are gonna start coming up to me and asking questions about.

There's a bunch of AI things on this. There's a bunch of machine learning things on this. We're gonna have to understand. General machine learning or artificial intelligence, you're gonna have to understand the distinctions between artificial intelligence, how they get utilized, how they get brought into the health system.

All that stuff's really true. Also, understand the curves and how they work. Health passports, gosh, that's just the concept scares the crap outta me. I don't know what else to say about that other than when I have to bring my health passport to go to a baseball game or, or send my kid to a certain school.

We've entered an or well in future. I'm not, again, I'm, I'm not excited about it. You might be so I'm not gonna comment on that. Any other stories here? No. Yeah, you, again, not harder to healthcare IT news. The name says it all. We really should be pretty easy to find the stories that we wanna find on that site and it's getting harder.

Alright, August print edition for Becker's State by state breakdown of 130 rural hospital closures. That was one of the, uh, things that we have to keep an eye on for the pandemic. Yeah. If you're in a metro area and you're a fairly well-funded health system, you're gonna be asked, how do you extend beyond the four walls of your health system?

How do you create connections to those rural locations, provide a level of care to those rural locations? I think that is gonna become. A common conversation probably pretty soon, if not already happening. But they have 12 key comparisons for Epic, Cerner, Allscripts, and Meditech. Interesting. Athena's not on there.

That's interesting as well. Yeah. Anyway, so probably worth a glance, although I don't think too many of us are thinking about changing our EHR at this point. Cleveland Clinic is advising United Airlines whose CEO says airplanes don't have social distancing. Another reason why United is one of the worst airlines in the country, followed closely by American Airlines, and they have gone back to booking flights at full capacity.

What can you say? I really have nothing to say. There's, I'm not sure there's a technology solution to it. I just wanted to tell you that I thought United was one of the worst airlines in the country. See, 29 hospital bankruptcies in 2020. Again, something to keep an eye on. It's gonna be an opportunity for some.

and it's gonna be a challenge for some communities. Kaiser terminates employee that inappropriately accessed 2,756 patient records over eight years. Wow. Yeah, just wow. But anyway, we've gotta keep an eye on those controls. And if you are a health, if you happen to be a practitioner who's listening to this just to understand health, it, every click, every screen you look at in the EHR is tracked, period, end of conversation.

And it's, it's tracked for a lot of good reasons. And this inappropriately accessing, we're required to understand are people reaching beyond their rights? And looking at patient records, they shouldn't look at. This typically comes up in the Hollywood kind of locations where, you know, Britney Spears checks in and somebody's going to make a lot of money selling it to Access Hollywood or whatever.

But it also happens in our communities, and it's one of the reasons that we have those security controls. Let's see. Kaiser returns $500 million in Cares Act payments. And that's great 'cause Kaiser made a lot of money. I think we read that their investments bounced back. They're, they're a payer provider, so their, their mix was a lot better than somebody else's mix.

They probably didn't need all the money that was allocated to 'em. Good for them. Fantastic. Again, it's probably appropriate for them to, uh, return money that they, uh, don't necessarily need, or, yeah. Don't necessarily need. Uh, COVID 19 to Cost hospitals 323 billion American Hospital Association. Yeah, I guess you can make numbers say anything at the end of the day, but you just go down a couple things.

Eight nonprofit health systems got $1.7 billion bailout and furloughed more than 30,000 workers. Anyway, there's a lot of competing things. You have to understand them in the context. Of what type of health system, what was going on in the community? What is their, their primary group that they're serving?

There's so many things as you read these articles, and you also have to understand people's interests more and more. When I read articles, I'm asking myself, whose interest is at player? When the American Hospital Association says, Hey, hospitals lost 323 billion. Billion. They're lobbying for something.

They're lobbying for more bailout. You have Kaiser returning 500 million. So you've gotta ask whose interests are do they represent? All right, last one. Uh, healthcare Innovation Group, Aetna Cleveland Clinic Launch. New model, ACO Co-branded Insurance Plan. Uh, I think more and more health systems are gonna look at COD and see that the payers did better through covid than they did.

It will be a risk mitigation strategy moving forward. It'll probably be a a must. For a lot of health systems to get back in that. So you're gonna see a lot of partnerships and plays where providers become payers. We are also seeing payers become providers. I think the distinction is gonna become hard to uh, figure out.

I. The not too distant future. All right, so that's the quick hits on the uh, four major sites that I normally go through. Alright, let me tell you why I was wrong. Lemme see if I can find this story. And the story is essentially. That the, uh, COVID 19 data will once again be collected by the CDC in a policy reversal.

All right. Hospitals are gonna return to reporting new cases to the CDC and prevention. Trump administration says, after a shift from HHS led to delays and data problems. All right, so this is interesting to me because this is gonna play out in a lot of different ways, right? It's very easy to step back and say.

But this was a mistake of epic proportions. We can use it for political gain. Let's trash 'em, and we're gonna hear a, a lot of trash talk about this. It was a debacle, don't get me wrong. They didn't get, gain enough input from the people who were actually, uh, providing the information. They implemented it pretty, it felt like pretty swiftly, pretty quickly in the middle of a pandemic.

It felt to me early on, like they were doing that because there were significant problems to the CDC database. Uh, they didn't communicate real well. We don't, we have a general idea of what we were gonna get. We were gonna get, uh, more thorough reporting and those kinds of things from the new HHS database.

Uh, but there's a lot of problems with it, and they didn't address a lot of those problems. So it was handled pretty poorly from beginning to end. It's a case study and whatnot to do. We talked about that last week. There's . If there's ways to do this correctly, gather the input from your, uh, constituents, especially the people who are going to put the data in and use the data.

They didn't do that. They didn't communicate real clearly on what the, the benefits were going to be to people. They could have piloted this very easily, and there's a handful of ways they could have piloted, to be honest with you. They could have had people continue to report to the CDC and create a secondary feed.

That would've come to HHS. That would've been a nice, easy way to do that. Another thing they could have done is they could have contacted, they could have taken the academic medical centers in who are fairly well funded, have pretty advanced data and analytics skills, would probably have had the ability to create the extracts pretty easily and just said, look, we're gonna run a pilot.

and we need you in very short order to start to create this extract and start sending it in both directions. And they could have done that very easily. They could have seen what works, what doesn't. Now, they would have done a secondary pilot as well. That would've given them some information about does their model work, does the collection work, does the tools scale?

Uh, like it should scale. Then they have to figure out how they're gonna get it from all these ancillary locations. States and other things, but there was ways to do pilots. There was ways to step into this, and sometimes when we're trying to move fast, we skip a lot of steps. It's a huge mistake. We've all made it, we, we, we really have all made it.

And so anyway, we'll chalk this one up to a very poor implementation on hh s's part. Here's what I'm gonna say about this though. I'm impressed. Here's why I'm impressed. A lot of times when we make a mistake in it, in health, it in other places, we don't own our mistakes. We, in fact, we fall in love with our mistakes and we, we ride them as long as we can and we try to, our initial mistake, we try to make better by

Doing something on the backend. CDC, I'm sorry. HHS could have easily have said, we're gonna continue down this path. We're gonna figure out how to make this work. They could have doubled down on it. They could have thrown more resources at it. Uh, a lot of health systems do this. A lot of IT projects have notoriously done this in the past.

They failed fast, right? This is what we want 'em to do. They failed fast and they said, Nope. Our one month experiment and going this direction was a mistake. And yes, it created a lot of angst, but we are gonna do the right thing. We're gonna own our problem. And, and they knew full well in an election year that this is gonna be used over and over again, but at least they went down the path of the right, uh, of the, the, the what was right for the country, what was right for the patients.

And we can argue. A lot of different things here. Let me tell you why I take this approach. Early on in my career, I was in a Fortune 500 company and I was a, an executive director. I was over a large swath of the country delivering services and those kind of things, and I was highly critical of the person who was in the VP role just above me.

And I was critical that, you know, they didn't do a good job. They didn't understand what was going on in the branches. They didn't understand what was going on in our clients. And I was young, I was late twenties, early thirties, somewhere in that timeframe. And, uh, I was highly critical and, and a humorous twist of fate.

The company filed chapter 11 and the person who was in that role left and I got the job. So I stepped into the very role that I was highly critical of how they, uh, handled the role. And what I learned in that very short period of time was, uh. It was a hard role and it was a lot harder than I thought it was, and the decisions were a lot more nuanced and sophisticated than I thought they were.

And I thought they were easy black and white decisions and they weren't. There was a lot more factors at play, and that was one of the learning experiences for me. And from that point on, I've given leadership a lot more leniency and a lot more leeway. Because I know that what I'm reading in the paper and what I'm reading in online and stories and tweets and those kind of things, a lot of times don't take into account what they're actually facing.

I'm only reading half, if not, if not a lot less of the story. I think there's stuff here to be learned. For us in health, it don't fall in love with your mistakes. The whole concept of fail fast, build a culture that's accepting of a failure as part of the process to getting better. So again, we're trying to create that in our organizations.

I'm gonna give, uh, HHS not a pass. It was a debacle. They handled this really poorly, but, but I am gonna give them a little bit of grace here and say, learn from this mistake. Figure it out, do it better the next time. And, and just like we would within our own, our own organizations. All right, I'm gonna hit a couple more stories.

Lemme check the time. Wow. The headline stuff really takes a lot of time. Alright, let me hit on this one. REI is going remote and selling its corporate headquarters. So REI is a great company. Uh, good reputation, uh, good culture. And they're essentially the, uh, company sells outdoor sporting equipment, that kinda stuff.

And they are getting rid of their corporate headquarters. Well, their corporate headquarters is not a small . Building by any stretch of the imagination. I hit this one real quick only to say how serious are we about work from home? And if we are very serious about work from home, how ready are we to get rid of our buildings for healthcare and health it or to redesign our buildings are building designed for, for everybody.

Working in the office is probably should be very different than our building design. For even a hybrid approach of people only coming to the office two days a week or those kind of things. If we're serious about this, we've gotta start thinking about what this means from a real estate standpoint. And then the second thing is, don't sell your real estate right now, especially commercial real estate, at night.

But yeah, 'cause the market is not gonna be that great, I wouldn't imagine in most locations. For commercial real estate. But with that being said, uh, I bring that up to say there's, uh, significant ramifications to, uh, work from home for us. Probably not right now, but we're probably gonna have to, uh, continue those conversations and consider it moving forward.

Let's see. Other stories, man, I got 15 stories here. Microsoft joins court battle between Apple and Fortnite Maker Epic. Now, why did I pull that one out? I pulled that one out because I think this is a precursor to a larger battle that we're gonna see in healthcare maybe a year or two out, and that is so Fortnite maker of the.

Massive GA or Epic is the maker of the massive game Fortnite. They were delivering it on the Apple iPhone. They violated Apple's store policies and because they app, they violated Apple's app store policies. They were kicked out. They were given some notice, but then they were kicked out. And it's interesting 'cause Microsoft joined the battle on Epic side, on the Fortnite side.

Saying that essentially Apple extracts more than a fair, uh, price for access to, to their, to their, uh, app store and, and that there are different technologies that would, uh, benefit the users that are being, uh, thwarted through that app store. This is gonna be an interesting case. I think it, it's worth keeping an eye on because in healthcare we may have the same thing.

I know that we have 21st Century Cures, which is saying . That the, uh, data's gonna get to the patient with a little no special effort or excess cost. But if it doesn't happen that way, if it doesn't just come down that way, I think you might see a similar court battle come up. I don't know what it'll look like, but that's why I pulled that one out.

To take a look at, uh, UCSF hack shows evolving risks of ransomware in the Covid era. This is a Bloomberg story, and the reason I pulled this one out was it's, it's, uh, again, based on the emails, it's startling that the. Essentially what UCSF is saying is, look, they, they kind tried to haggle with the, with the, um, with the ransom ransomware.

What are the exhorters, extortionists, whatever it is, they tried to haggle with them and essentially said, Hey, this is being used. This data's being used for, uh, to develop a treatment for c Ovid 19. Develop a vaccine. Uh, we need this data back. Can you help us? Now, we don't know if this was just a negotiating tactic or what it was.

But at the end of the day, UCSF was not prepared. They clearly didn't have a backup of this data, or they didn't have ac, they couldn't recreate the data. Let's just say it that way. Or the, or. The recovery point objective was, was so much they would lose too much data either way. It wasn't well thought out.

Something to be, something to consider in your, in this, in this era that we're in, this ransomware era that we're in is . To really go back and look at all of your backups. I remember when I did that as ACIO, I had them do an audit of all of our backups, and it was alarming where we were at. This is one of those areas that if you don't keep an eye on and don't keep good sound, uh, operational practices around you will, you'll fall behind and you'll start missing things.

Uh, here's the, uh, another security one US charges former Uber Security Chief. With covering up massive 2016 hacking. I'm not gonna go into the story. I think that the title says enough right there, bottom line, they should go after 'em. We should not be covering those kinds of things up. I think we know that in healthcare, but it is, it, it is worth mentioning that when a breach happens that we need to report it.

I think we all know that. I think we know we're all responsible for doing that. I, I, I don't know of any health systems that are getting caught for that. And a, a startup is probably more prone to that kind of poor decision making. But just a reminder, last story. This is it. McKinsey wrote an article, ready, set, go.

Reinventing the organization for speed in the post C Ovid 19 era, and this is one of the things I wanted to focus in on speed and agility, we have to get faster and how do we get faster? We have to look at how do we deploy talent? How do we redeploy talent? How can we launch, how fast do we launch new business models?

How good are we at improving productivity over time, uh, incrementally or, or more broadly? Um, how fast are we developing new products, shifting operations? Clearly, McKinsey wrote this article not specifically for healthcare, uh, but for businesses in general, and what they're saying is COV has changed everything.

It, it didn't really change everything. We were already here. It just made it obvious to everyone else, there's a need for speed and we're not turning back. . And so they go into reinventing the organization for speed, rethinking the ways we work, reimagining the structure, reshaping the talent, who we hire, how we deploy 'em, where we put 'em.

The, uh, we need to speed up and delegate decision making. So decision making can be made faster with people who have the information, who are more, uh, in contact with, where the decisions will do the, the most good. We need to get them the information, give them the, the right structure to, to speed up decision making.

step up execution excellence as they go on to say, just because the times are fraught does not mean that leaders need to tighten control and micromanage execution, rather the opposite. 'cause conditions are so difficult, frontline employees need to take on more responsibility for execution, action and collaboration.

And I want to echo that as great words to live by. A lot of times when we get into these things, we think I know what to do, but no one else knows what to do. Therefore, I'm going to bring more control in. Worst thing you could possibly do. And Stanley McChrystal had a great story of how they were so far behind in battling the Taliban and others because they had distributed control and, and command and control, uh, type of, uh, decision making.

And, uh, everything for the US was centralized. And it wasn't until they, uh, distributed that command and control that they started to make the decision making. I keep saying command and control, the decision making, that they were able to, to thwart the, and actually make progress in that, in that battle.

Cultivate extraordinary partnerships. Working with partners is routine, but the speed of action only goes so far. If other players in the ecosystem fail to move just as fast. . Okay. And I think the other thing is cultivate extraordinary partnerships at scale and at speed. One of the things we did when I was ACIO is we looked at, hey, we need to bring in all these, these, uh, potential partners, but we set 'em up for a legal process.

It takes three to six months to get through the gauntlet. And so what we created was a short, repeatable contract for new partners where they could get into a sandbox. Work with not even de-identified data, just fake data and, uh, prove out their systems. And so that contract was really easy to get signed, really easy to get people up and running.

They were working on our systems with fake data so that they can prove out that their, that their solutions worked. And then over time we could then move them into more structured contracts. 'cause if their stuff didn't work, there's no reason to go through the big contract anyway. And if their stuff did work.

Then it would take them some time to prove it out. We would get to see that and we could get the, the true contract to get to de-identify data, and then potentially live data. Flatten the structure, unleash nimble, empowered teams. The Pan Pandemic has seen a large scale deployment, a fast agile teams, small focused cross-functional teams working together towards a common set of objectives.

This is, uh. Make hybrid work field. Tomorrow's leaders today learn how to learn. These are all great concepts. This is a really well done article. I say this to say, we need to do this in healthcare. This is how we need to be thinking. We need to be thinking Agility is the most important. Attribute, I think we're going to ascribe to a health system moving forward.

The story is ready, set, go. Reinventing the organization for speed in a post c Ovid 19 era. If you get the chance, hit the McKinsey site, download that, read it, share it with your team. It is a great conversation piece for, uh, your team to go through. That's all for this week. I rambled a little bit, getting used to this new format.

We will, we will continue to get it down a little tighter as we go. Don't forget to sign up for clip notes. Send an email, hit the website. We want to help you to be more productive and to maintain your commitment to your staff to keep them current. Special thanks to our sponsors, VMware Starbridge Advisors, Galen Healthcare Health lyrics, serious Healthcare Pro, talent Advisors, and Health.

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