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 Welcome to this Weekend Health it. It's Tuesday News team where we look at the news which will impact health it. Today we're gonna go deep into a bunch of stories. We're gonna take a look at a, uh, list of the CIO must doss from, uh, David Chow, and I'm gonna give you my own list. Uh, we're gonna take a look at, uh, the Amazon Berkshire, JP Morgan Haven venture, and, uh, what is going on there?

Uh, we're also gonna take a look at, I don't know where tech spending is gonna go post, COVI, uh, a little work from home, bunch of other stuff like that. So, um. Looking forward to it. My name is Bill Russell Healthcare, CIO, coach and creator of this Week in Health. It a set of podcast videos and collaboration events dedicated to developing the next generation of health leaders.

This episode and every episode since we started the Covid to 19 series has been sponsored by Sirius Healthcare. It is their commitment to making this content available that has made the daily episodes possible. Special thanks to Sirius for supporting the show's efforts during the crisis. Uh, we have a live episode this week.

This Friday, uh, from 11 to 12 Eastern time, we are going to talk about funding Telehealth's Future with a great panel and your questions. Uh, Mari ques chime, public policy Pravin Chopra, CIO for George Washington University. Stephanie, Dr. Stephanie Lar, uh, C-I-O-C-M-I-O for Monument Health. And Bert Orel with, uh, rainy Children's in San Diego will be joining me.

Um, . MA's gonna share some, uh, some insights to get the discussion going, and then we are gonna talk about the future of telehealth funding, uh, with the panel and you actually mark it on your calendar. Invite a friend, love to have you join the conversation. Okay, let's get to the news. I'm going to challenge myself to cover as much as possible in 25 minutes.

Here goes, uh, David Chow. Put out an article. . In the, uh, Forbes contributor network, it says, don't sleep healthcare CIOs must step into 2021. Now, um, you know, I love the title. I love the concept. In fact, I'm gonna pull it up so I can give you some of these real quick, uh, top initiatives for 2021 and beyond.

I. I don't know if he if this was updated for, oh yeah, it's updated for covid. Okay, here we go. Uh, top technology initiatives include virtual care, mobile initiatives, remote patient monitoring. That's number one. Number two, foundation technology emerges as a priority with every organization's expansion strategy.

Uh, number three, healthcare leaders rethink their physical expansion strategy. Uh, organizations face enduring effects of post covid. Number five, operational excellence, excellence mask itself as another way to say cost cutting. Number six, focus on value-based programs Miss, uh, misses the mark on population health.

Number seven, providers must make strategic cloud ERP decisions. Number eight, administration emphasizes clinical satisfaction. Number nine, health systems go global. Number 10, information security. Risk. Exposure tops, all priorities. Alright, well, you know, again, I love, uh . , uh, you know, I love a good top 10 list.

Um, but what I'm gonna do is, uh, rather than comment on his list, and, uh, what I'm gonna do is, uh, give you my own list, which is what you tune in to here for. So I, I'm gonna drop my list. Some of it overlaps with David. Um, the business of healthcare will not bounce back in 2020. Financial pressures will be the underlying theme for the next 18 months in healthcare.

For that reason, here's what I'm thinking about Telehealth. . Know the funding sources and keep your program aligned to it. It may sound heroic and cool to be the digital leader of your organization, but without funding, telehealth is a bad strategy for healthcare providers in most cases. Uh, it cannibalizes the business.

Uh, don't get me wrong, it is absolutely the future of healthcare, and it will be hard to explain to people why they may no longer be able to see their doctor online and have to sit in a waiting room, which is . Barbaric as we now know. Uh, but if you serve the organization that you are employed by, you have to make decisions that strengthen them and not weaken them.

Uh, if you want to go full on telehealth and virtual strategies, then you have to have covered lives. That is, you have to be paid to keep people healthy, uh, to keep them out of the hospital. Uh, you know, the work is in pushing the government and the commercial payers to continue to fund telehealth. If they do go crazy.

Really go crazy. In fact, I would say any CIO that isn't working on a plan for integrating virtual care and home-based care strategies is missing the boat. If I were ACEO of a health system, I would ask for a plan that would be probably jointly developed by the C-M-O-C-M-I-O, uh, operations, uh, COO and CIO.

Um, I would say to people, get to work on this today, uh, yesterday actually. Um, but anyway, I'm gonna get into more of this in the next item. My next item is a theme which we covered in January. Asset light Strategies. This was one of the key themes for the JP Morgan Healthcare Conference. A lot of health systems are doing this, uh, figure out how to make a solid move into a market without planting a billion dollar seed in the ground, and hoping that the acute care hospital will grow into a profitable business Asset.

Light strategies include retail strategies, partnerships, and products, uh, primarily digital products that appeal to the consumer directly. Leverage your brand to make a move into a new market. You know, I covered this in detail at the, uh, in the beginning of the year, uh, the j the, uh, JP Morgan show. Uh, we talked about Baylor Scott and White's move into Austin, Texas.

Uh, have a listen and figure out . Uh, a much better way to spend a billion dollars. You know, what's, what's it role in this? Well, um, you are actually right at the core of this strategy. Asset light strategies are digital efficient and adaptable. Telehealth becomes an offensive weapon when trying to go into a new market.

You aren't cannibalizing anything. When you go into someone else's market, you are planting your flag, you're creating a business around a new model. Video visits becomes the foundation for a new model of care. Uh, the key is to match the cost model and the revenue model. I did some work for, uh, Edward Jones, a, a a while back.

Gosh, feels like centuries ago. Uh, and it was probably almost two decades ago. Um. . And, uh, you know, the thing about Edward Jones is they were opening offices when everyone else was closing them down. And, and, and they're financial planners. I asked one of their IT leaders at a strategy session. We were having, um, you know, how they could be opening all these offices and, uh.

And he said they could open an office in only a few weeks, which included getting the contracts done. They had a complete office in the warehouse ready to ship at a moment's notice. They had automated just about every aspect of opening an office, and thus they drove the cost out of the equation. So they're off, you know, their office in everywhere.

USA became a differentiator and the rest. Of the industry started following. I, I mean, now you drive down the street and you see all these, uh, banks and places, uh, popping up. You know, chase has opened up more and more locations and they're going into more and more remote locations. That is the nature of asset light.

Take those strategies into new markets and expand your brand at the expense of someone else. And yes, healthcare is a business. Um, my third one is gonna be dust off your m and a play playbook. Uh, the government money isn't going to be enough. The revenues will appear to be coming back to normal quickly, uh, but they won't return to pre covid levels, uh, this year.

Uh, they will be slow to return to those levels and it will put immense pressure on healthcare balance sheets. Expect to have opportunities, expect to have hospitals offer. . The system, you know, your system, the privilege of taking on their problems for no money at all. They will literally hand you the keys.

Expect medical groups to be looking for cover, expect large systems to continue to jettison underperforming assets in markets that haven't been able to really, they haven't been able to establish essentiality since they started there. So what's it role in m and a? Uh, we have to be more efficient and start being more clear.

So let's start with efficient. We can't take three years to integrate a new system. It has to be done in like 12 months. We just showed we could do amazing things in short periods of time. We have to get better at the m and a stuff. Um, you know, it is not rocket science. Um, the clarity comes in letting people know that there is a cost for running duplicate systems, and eventually we will be moving to a single system.

Please, please, please don't tell an acquired entity that . They won't be changing any of their systems for 12 to 24 months. This is the silliest thing you can possibly do. It's poor leadership, consolidate IT systems. Get to a single E-H-R-E-R-P PACS as fast as you can. You've gotta drive the cost out of this equation.

You have to get the operational efficiencies. You have to get the ability to drive quality higher, and a lot of that requires to be on the same system. Now I can put together strategies for multiple systems, but I, it is generally better if you're all on the same system. Uh, number four, cost cutting is the norm for the foreseeable future.

I know. Tell me something I don't know. Um, well, how does it play in this situation? Figure out what your system's posture is going to be post covid, even if you're Furloughing staff that, that, um, they may want to be aggressive. coming out of the, the, the crisis. And you have to understand that, um, how can you move faster if you have less staff?

Simplify, consolidate, eliminate, change the culture. You have to value efficiency, reliability, and security. Absolutely. But what about agility? , you know what systems will give you the quickest time to bring new medical groups or health systems on board. Agility is the metric that is of the highest value in and coming out of a crisis.

Also, here's where I really want to talk about work from home. Not not in detail, but you know, we have to figure it out. We have to make it work. This is a cost savings move, and it is a game changer in hiring the best talent. Uh, next thing, uh, reevaluate every project. I've talked about this on the show a couple times.

Um, you have to ask yourself, do the factors which led to the project being funded still hold true? You may not have the same amount of staff. For starters, I. Capital may, may be frozen. You have, uh, a majority of your staff working from home in the near future, so it's role is to look closely at the resources and make sure that you have them aligned to the most critical needs.

Ensure that the assumptions for resourcing the project still hold true. Does the project hold up in a post covid world as the project that you should be funding right now? As a side note, you know, I, I really do, I hate the annual budgeting in healthcare. I understand. I, I really understand why it has to happen, uh, but I do hate it.

The, you know, the process is so time consuming that it can't possibly happen more than once a year. However, that means that we are deciding on what projects to fund 18 months in advance. That is, by definition, slow. And it's, it's slow. It's not nimble. It's, you know, it's turning a ship very slowly. What if we had a way to have six month budgets?

Would a health system that figured out how to allocate their funds to the most important projects every six months have an advantage over the competition? I think so. Uh, the final final one I'm gonna give is, uh, 'cause I just wanna move on from this platforms. I've talked about it before, so I'll, I'll go light on this today.

Uh, configuration over coding. Pay for what you use, ubiquitous access, security by design. Um, you get the picture. Platforms are, um, are more efficient. All right. That's probably enough for that. Um, let me keep going. Let's see. Amazon, Berkshire, JP Morgan Health Ventures fails to disrupt. This is a Bloomberg article talking about Haven.

So when, uh, Amazon, Berkshire Hathaway and JP Morgan shakes announced their formation of Haven in January, 2018 to extend the rise of employer healthcare spending, the world expected big results rather than disrupting Healthcare Haven find itself in disarray. With its top two executives departing in the past year and the venture giving few clues as to how it's going to slow the upward march of health costs in America.

So we've talked about this at least twice on the show. We talked about when it came out, they, uh, hired a tool, Gawande, a surgeon, Harvard professor, high profile expert in the field. Um, and he resigned abruptly and is now, he still has a role there as, uh, the venture's chairman. He's devoting his time to the, uh, COVID 19, uh, pandemic.

Um. , you know, but what, what people, what analysts are saying, who are looking at this, is it looks like they were incre incrementally iterating on something that looks much more like the status quo than most people were anticipating. And that's from, uh, Jeff Becker, senior Analyst for Forrester Research. Um, it didn't feel like Haven early on, was focused on the key blocking and tackling, says Alan Miller, CEO of Consultant Cope Health Solutions.

Uh. Uh, another one, uh, Haven said all the right things at the start promising to be relentless in articulating a mission to deliver simplified, high quality and transparent healthcare at reasonable cost. It's a worthy goal. The average cost of healthcare was $13,000 per employee. In 2019 with workers shouldering about $3,000 of that in annual paycheck donations, according to Willis Towers Watson.

Um, you know, Haven wasn't the first one to do this. There was a coalition, health Transformational Alliance, Amex, IBM and Macy's, um, which was about 4.5 million people that they were trying to cover. And they did work around that. Um. Health consultants agree that in order to ring out costs from the systems, employer plans need to ensure that the doctors are being financially rewarded for lowering spending.

So it's gonna require a little different, uh, mindset. Um, the one I always keep coming back to is Walmart. Um. They actually, uh, talked about it in this article. Another way is, is by pointing patients to the best performing doctors in a given specialty to ensure better results. This isn't easy for large national employers to do across the nation, given the amount of work it takes to identify high performing medical groups in local markets, but at least one large employer is starting to try.

Walmart, Inc. Is rolling out a program this year to direct employees. . To higher performing doctors in Arkansas, Florida, and Texas. I'll tell you what, if I were a provider in Arkansas, Florida, or Texas, I'd want to know where I rank on the Walmart scale. They're, you know, I think, I believe they're still the largest employer in most states.

If not, uh, still in the country. Um, I would want to know where I rank. . And, uh, they've done some other interesting things in, in terms of, uh, second opinions and whatnot, really trying to drive down the, the, uh, cost of care. So, um, you know, we're gonna keep an eye on this one. You know, America spends about $3.5 million, uh, 3.5 trillion.

Annually on healthcare. Uh, employer coalitions have been searching for ways to lower these costs, um, for a long time. Um, it's believed that there is a great opportunity here. I think Walmart has a, uh, distinct lead. Um, the other players, you know, the Amazon, Berkshire, and uh, JP Morgan are innovators each in their industry.

And, uh, I think we can still expect some big things from this. And we'll have to see what, where, uh, leadership goes with this. Uh, I wanted to highlight a tweet from Ray Wang on tech spending post pandemic. So he has, uh, how it's gonna shift by industry. Um, interestingly enough, you know, travel and hospitality tech spending's gonna go down by 27%.

Is there a source that's Constellation Research? So it's, it is Ray Wang's. It's actually their research. They probably did a survey of some kind. Um. So 27% decrease in travel and hospitality as you would expect. Energy and oil, 22% down. Automotive, 21% down. Uh, you go up retail about 13% down legal, uh, 11, 12% down.

Education, engineering, uh, three 5% down. Telecommunication is about 3% down. Then you have real estate, 3% up healthcare, 10% up, uh, food and beverage, 11% up. Government, 13% up. Uh, those are just some of the numbers. I, to be honest with you, I hope that is true. I don't believe it's going to be true for most of healthcare, but for the aggressive players, uh, I believe that they are going to double down on tech spending, uh, in healthcare.

And we're gonna see a growth in that number. But I think we have to be . It's not gonna be on traditional projects. I don't think it's gonna be on traditional projects. And I, I think this time of having these massive it staffs, um, that are not nearly as efficient as they are in other industries. If you look at other industries, I've, I've talked to CIOs from other industries and when, when I tell them the amount of people.

We have per dollar coming in. They just, they, they, they just cannot believe how many people we have and how many people it takes to run a healthcare organization, uh, at least from the IT side. So, I, I, I think there's gonna have to be some changes. We're gonna have to adopt some digital technologies, uh, some automation.

We're gonna have to look at, uh, you, you, uh, you know, just technologies that require less people long term. Uh, okay. Angel Le Yoakum was, uh, quoted in an article. Where's that article? Uh, I forget what the magazine is. I apologize. Um, but, uh, they asked a bunch of CIOs not necessarily from healthcare. Uh, she's the EVP, chief Digital and TRA Technology Officer for Nvo Health, and she was talking about work from home and she said, forward thinking companies will recognize the power in adopting remote work as the norm rather than the exception.

Companies that encourage remote work can cherry pick differentiating talent from anywhere in investment. Can be shifted from facility costs and travel expenses to innovation. Using fluid teams and being nimble were essential capabilities even in the pre pandemic economy. But even more so, uh, even more so now as our future becomes less predictable.

I. Uh, she closes this out by saying what we learn about our cultures, our reliance on past norms, and our ability to adapt quickly will be tremendously valuable as we adjust our long-term strategies and we'll determine which companies and industries thrive in the new world. Uh, a lot of people talking about remote work, I think it's here to stay.

Um, but I don't think you're gonna see the entire IT team, uh, work from home. I think we're gonna have to really think this through. I think it's time to do surveys with your staff and, uh, figure out what is working, what is not working. Uh, there are clearly some people that cannot wait to get back to the office when it is safe to do that.

Lemme check the time real quick. Uh, we're at about 20 minutes. I'm gonna, I'm gonna hit one last thing ish. Uh, I'll do it quickly. The CEO and Board Playbook for Leadership through Technology Transformation. Russell Reynolds sent this out. I got it in email. It's actually a pretty good, um, pretty good article.

It was written in April, April 17th, 2020. And, uh, they talk about, you know, how, how to set up your organization for addressing the, um, . The, uh, technology transformation that's required. And they talked about, uh, 2019 MIT study shows that having multiple tech savvy directors on the board contributes to above market performance in both revenues and profitability.

And, uh, they go on, they have a, they have a pyramid here, aligned, go, uh, aligned, go to market functions, digitize core businesses and functions and operating models, build scalable technology platforms. To support the business scalable technology platforms. You're gonna hear that over and over on this show.

Um, and then the bottom is move to customer-centric data-driven and agile culture. There you go. And they talk about best in class. They have a, uh, some excerpts about Disney, Goldman Sachs, Nike, Ikea, Siemens, Merck, and MGM Resorts. Uh, Heineken. Wow. Just go on. There you go. Uh, so worth, worth a look. Uh, I'm not gonna cover it in detail.

And then the last thing I will cover, please step away from the base runner. Why baseball 2020 won't be much fun. So they released a massive book for how we can safely play baseball. And, uh, let's see where we're, I have it. Baseball might not be fun this summer. And, uh, 67 page outline. Of ML B's, new health and safety protocols highlights how different the game will look.

If players are able to take the field this summer. Um, I think this is a moot point because they cannot get to an a, uh, understanding on the financials, how much they're gonna pay the players. They're gonna pay 'em for half a season. What? Um, and because they can't get to that agreement, um, . You know, coming back safely doesn't really, um, playing the game safely doesn't really matter until they can figure that out.

Um, which really makes me sad since baseball is the sport I love to watch, um, more than any other. So, um, we'll see if they're able to figure that out. What's the practical application for that? I wanted to talk about that story 'cause I love baseball and wanted to close with that. But you know, the practical application is we've gotta take care of some things before we ask people to go back to work.

Uh, we have to take care of the liability. We have to take care of, uh, contact trace. I mean the, we have to provide for the safety of people. Um, who are going to have to go back to work and serve others in their, uh, capacities. We just have to do it. We have to think it through. Um, I applaud MLB for coming up with this, uh, framework.

I hope they can figure out the money, uh, to move it forward. So. That's all for the news. Um, special thanks to our sponsors, VMware Starbridge Advisors, Galen Healthcare Health lyrics, pro Talent Advisors, and Sirius Healthcare for choosing to invest in developing the next generation of health leaders. This shows the production of this week Health.

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