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 Welcome to this week in Health IT News, where we look at as many stories as we can in under 20 minutes or less that will impact health it. It's Tuesday Newsday, and here's what we have on tap. The Trump administration's preparing an executive order on health cost disclosure. Equifax, just, Equifax just became the first company to have its outlook.

Downgraded for a cyber attack plus a couple other stories. My name is Bill Russell, recovering healthcare C I o, and creator of this week in Health. It instead of podcasts and videos dedicated to developing the next generation of health IT leaders, this podcast is brought to you by health lyrics. Have something within health IT that's going sideways.

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So let's go. Uh, let's go to the news. So the Trump administration's preparing an executive order on health cost disclosure. This story's in the Wall Street Journal. It's also on Market Watch. And let me read a little bit from this. So, president Trump is expected to release an executive order as early as next week, and of course this was written last week, so we can expect it this week to mandate the disclosure of prices.

In the healthcare industry, according to the people familiar with the discussion, the order could direct federal agencies to pursue actions to force a host of players in the industry to divulge cost data. The people said, the administration is also looking at using agencies such as the Justice Department to tackle regional monopolies of hospitals and health insurance plans over concerns.

They're driving up the cost of care according to people who are in the know. So I. You know, I don't really wanna get into the politics of this, uh, too much. You know, economics 1 0 1, it, the Trump administration is trying to create a market for healthcare and economics 1 0 1 would tell you that to create a, create a market, you need a consumer or supplier.

You need choice, and you need, uh, that choice to be informed by information on the product, such as price and quality. In healthcare, we have a limited market. We have limited number of suppliers, limited choice, and one of the things they're attacking right now is there's almost no transparency on cost or quality data for that matter.

In short, there's, there's, there's no market. So that that camp is saying, Hey, if we unleash the free market on healthcare, Which starts with price, transparency and, and, uh, ac accessibility to data. I mean, you're seeing all the things from c m s that are sort of saying, Hey, we want to make a market out of this.

Because in other industries where we have a market, you know, prices tend to normalize, performance tends to go up, and you have the competitive nature, competitive forces of a market. So that's what one camp wants to do. The other, the other camp. Is looking at it saying, Hey, you know what? There's another way to do this.

And that's to aggregate the purchasing power and aggregate it all behind the government, right? So Medicare for all Medicaid, Medicare for all. You end up with as many people as possible behind this one insurance product, if you will, and they're purchasing. And because they're purchasing now, they can, they can really dictate and mandate what the uh, health systems are going to be doing.

And, uh, you know, one way or the other, I'm not gonna talk the politics of it, but the, the suffice it to say we're entering a, an election year and neither party is really a fan of the status quo. So something's gotta give and my so what on this story is within the health it, we always have to be designing for agility.

Um, you have to be, you know, today we're sharing our pricing. Transparency was as simple as take your charge master, create a spreadsheet, put it out on your website, and share the data. That's, that's great, but that's probably, that's not that great actually, but it's probably not gonna cut it in the next round, and we have to be ready to move very rapidly, very fast, very rapidly.

In this changing market, especially the, the, uh, market where the government forces are, um, really going back and forth on this issue. You've, you've gotta be able to create IT systems and infrastructure and data models. And analytics that are gonna be able to rapidly move with not only the market, but also with the regulatory environment that we are going to be living in.

So that's the, uh, that's the first story. That's the, uh, Trump administration preparing executive order on health cost disclosure, wall Street Journal and Market Watch. The next story, you know, I find interesting, it's not necessarily in healthcare, but Equifax just became the first company to have its outlook downgraded.

For a cyber attack, and this is in, uh, on C N B C. And you know, the two key points on this. C N B C is nice. They just give you the two key points. Uh, a Moody's spokesperson said the downgrade is significant because it is the first time that cyber has been named as a factor in an outlook change. The second thing is Equifax Equifax's breach in 2017 will have a lasting effect.

On the company's security spend and infrastructure costs. Moody said, you know, I, it's, I, I pulled this story out because I think it, it, uh, informs where things are gonna be going. One of the things that's fascinating to me is we've had a, a fair number of, uh, breaches within healthcare, and it really hasn't impacted any health system or, or even payer for that matter.

The, the, what happens is, You know that you have the breach. We all receive the, uh, you know, the, the credit protection, uh, information. We get our alerts and whatnot, and, you know, they're gonna protect our identity and do all that stuff, which is all well and good. But I would, I would imagine if you actually looked at the statistics, because we have very little choice in our healthcare decisions, uh, a majority of people don't leave that health system because of the breach.

Well, that's one aspect and, and so health systems have sort of gotten away with it, but this is a completely different aspect and my So what on this story is. Is what this could mean for healthcare. If, if the ratings agencies are actually looking at Equifax saying, Hey, this cyber attack is indicating to us that your, your cyber spend, your infrastructure costs, your security spend, and you know, your PR spend for that matter around this incident are going to dramatically impact your costs.

They could potentially do that same thing to healthcare for the next major breach that comes down the pike. They could look at the health system and say, look. We think that your security spend, your infrastructure costs is all gonna go up. So my, so what is, if you're a board member, I would take note of this because, you know, this is, these are the rating agencies.

If your bond rating changes, a significant amount of things happen within a health system, and your cost of money goes up, when your cost of money goes up. Then it's, uh, you know, it's harder to buy things. It's harder to, it's harder to do those bank infrastructure projects. It's definitely harder to do the IT projects.

And so, um, my, so what is that? Board members need to keep an eye on this and make sure they're asking the right questions of their IT organizations. And if you're the IT organization, make sure your board is up to speed. They understand what you're doing, where you're taking things, and, uh, fill all those holes.

I, to be honest with you, you know, the, the number of attack vectors on healthcare is pretty significant given the number of applications I. Given the fact that there's so much legacy, given the fact that so many biomed devices are so old, and, uh, you know, our networks have not been, uh, kept up. Uh, we have not put the infrastructure spend year in, year out to, uh, maintain our, our networks at, at a top level, and that's a requirement at this point.

So, uh, so that's the So what of that story? So, you know, Equifax just became the first company to have its outlook downgraded. For a cyber attack on C N B C. Take a look at that story. I think it's interesting and something to keep in mind for the next major healthcare breach. So my next story, uh, you know, I don't usually do this, but my next story is an internal press release.

It happened to get picked up by the N B C affiliate in the local market, but I think it's indicative of what's going to a trend that's going to be coming down the pike in healthcare. And that is L I S C and Atrium Health Team, up to Link Health related Services, . To affordable housing development through Charlotte Investment Fund.

And, uh, let me just read a little bit of this. The joint strategy is moving forward thanks to a contract awarded from Fannie Mae's Sustainable Communities Innovation Challenge, an open competition, exploring innovative ideas that help address the affordable housing crisis in America. Five proposals received funding as part of the second phase of the $10 million Initiative, which focuses.

On the intersection of affordable housing and health, L I S C and Atrium Health will use the contract award to develop a new financing mechanism that will address social determinants of health, such as employment and access to healthy food as part of a holistic approach to housing development through, uh, C H O I F A joint effort among foundation for the Carolinas, the City of Charlotte Corporation, and a philanthropic.

Organization to expand the city's supply of quality housing. L A I C is the fund manager, so forth and so on around the housing units. Uh, it goes on to say, and I think there's some, some other good stuff here. So it goes on to say other Fannie Mae awardees announced today are working in Illinois, Jersey, Montana, and DC to test new approaches to significant community health challenges.

In addition, To leading the effort in Charlotte, L i s C is also a partner in the DC plan led by the city's National Children's Medical Center to address high rates of asthma in some neighborhoods. And here's a, I'll close with this, a really good quote here In underserved communities, affordable housing and health outcomes of residents are inextricably linked.

Research shows that poor quality housing can have a direct negative impact on person's health. I said Maria Evans, vice President, sustainable Communities Partnership and Innovation at Fannie Mae. The five ideas we have chosen to pursue have a potential to reimagine housing as a prescription for a healthy life.

That's an interesting phrase in of itself. Reimagine housing as a prescription for healthy life. We look forward to supporting those innovative solutions and to working with all the contract awardees. You know, again, I pulled this out because I think this is a trend we're gonna see over the next couple of decades, uh, or at least the next, next decade, which is healthcare organizations are really leading the way in these partnerships that, that, you know, deliver health and go beyond just delivering healthcare.

And so it's taking social determinants, is creating partnerships, uh, across, uh, these boundaries and, uh, really starting to address the needs of the community. You know, so, so what for health? It, the so what For health? It is, again, we're reaching beyond the four walls. We're reaching beyond the boundaries of the health system.

And anytime we do that, we need to get really good at, at security, we need to get really good at, uh, sharing of data at analytics, uh, at bringing in new, uh, sources of data. And, uh, and, and sharing that data across those boundaries. And so that becomes the so what for health? It you just, there there's no such thing as controlling the whole, uh, the whole solution set within the four walls of the health system anymore.

There's gonna be so many solution sets that require data sharing, APIs, uh, security models that, uh, go down the, the entire solution stack. So, uh, again, very interesting story. That is, uh, L I S C, atrium Health Team, up to link health related services to affordable housing development through Charlotte Investment Fund.

And, uh, you know, and I just love that quote, the five ideas we have chosen to pursue have the potential to reimagine housing as a prescription for healthy life. Awesome. Uh, my last story, so last story for this, uh, for today is five tips from Northwell Health. For engaging health consumers, this is, uh, moby health news.com.

And a little bit of a spoiler alert, you may not need to read this story 'cause I'm gonna give you, I'm gonna give you all five of the, uh, of the tips from Northwell Health. I think it's worth discussing and I think it's worth getting out there. So the, uh, the first tip is solve the right problem. And here they, they sort of balance between a patient first approach versus a technology first approach.

And, uh, you know, they, they take a little dinging at, uh, it over the years of taking a technology first approach, like with, with, uh, meaningful use and other things, I. And they say, you know, we need to, we need to go patient first, patient-centric, figure out what, uh, solutions work. I don't like patient-centric because I think it, uh, doesn't take the entire solution set in in mind.

We've gotta think of this whole solution set. Sometimes it's patient, uh, you have to look at the entire ecosystem. So if it's patient provider, it's solution centric. So patient first approach, patient centric approach, I'm not sure that makes the most sense. I think it makes the most sense to look at.

What's the best solution we can deliver, um, for that specific problem. So solve the right problem. The second thing is, go back to basics. I like this one. So the first step in Northwell's digital transformation was to conduct interviews with both patients and staff, asking them what they would want in a digital patient experience.

And, uh, you know, that's an important point. I think, uh, Jonathan Manis made that point. You know, a lot of times we talk about, Hey, you gotta go out and interview the patients, and I think it's important to. Interview the patients and bring them together and ask them questions. But our health systems are loaded with patients

We are all patients, and we could, uh, you know, we could probably design a pretty good solution that would reduce the friction and, uh, improve the, uh, outcomes, transparency, and costs. Uh, across the board, uh, just by talking to the, the internal users of our health services, uh, the, the staff that we, uh, currently have.

So, um, but again, number two. So number one, solve the right problem. Number two, go back to basics. And I guess there, there approach there for going back to basics is ask people, interview people, talk to them, find out what they're looking for. The third thing is, uh, learn from retail, but don't blindly emulate it.

So I'm just gonna read this quote 'cause it's, uh, pretty fascinating. Customer journeys value people for the dollar they control and the goal is increased consumption. Okay, so that's outside of healthcare industry. They're saying customer journeys value people for the dollar they control. And the goal is increased consumption.

Patient journeys value people because, and so this is patient journeys within healthcare, patient journeys value. People because they are people, and the goal is decreased consumption of that sick care. Fundamentally, this is a difference. Healthcare requires specific considerations around empathy, privacy.

Empowerment that are different from other industries? Uh, you know, I'm not gonna argue that. I will say it's, um, kind of an arrogant, uh, point to, to, to make , just to be honest. I, I think it's good. We need to learn from retail. Don't blindly emulate it. Uh, I just don't like the arrogance of the statement to say, you know, every other industry doesn't really care about the person.

Uh, whereas healthcare is the only one that caress about the person. I, I, I don't think that's true. I think that's, uh, uh, uh, it's is a little jaded way of, of viewing the rest of the world. Um, you know, apple has made my life better, so has Amazon, so has Google. They've all made my life better. And, uh, I'm not sure that all of those things were, uh, commercially motivated.

Um, it has commercially benefited them, but I'm not sure they were all commercially, uh, motivated. 'cause that is to say that everyone within those organizations thinks that way, and I don't think they do. So, um, I, that's a little tangent on my part, but, uh, I agree with the point, learn from retail, but don't blindly emulate it.

We do have some different requirements. I like the second half of this where they talk about empathy, privacy, and empowerment. I think those are all. Very important, uh, considerations as we move forward. The fourth thing is don't neglect your people. Um, which is an interesting way of saying this. The, the, uh, article really talks about getting buy-in.

At this point, if you don't get buy-in across the entire organization, a lot of times we talk about get executive buy-in. And that's important, but it's, it's really across the board. 'cause you'll end up with, uh, silent vetoes, you'll end up with, uh, just all out, out now pushback. And the reality is a majority of these projects are not technology projects.

They're operational projects and, uh, they're operational projects that are supported by technology. And they need to be thought of that way. And for the most part, the c o o should be driving a majority of this. Uh, consumer, this, this digital consumer should really be driven by the chief operating officer.

And that's kind of a, a little different, uh, approach. But to be honest with you, 90% of what needs to change or needs to happen is gonna be under the c o o. So unless the c o is working, uh, closely with the, uh, chief information officer, innovation officer, digital officer, whoever it is, Uh, these projects are going to move slowly, get stalled and those kind of things.

And, and for the most part, I would say your chief operating officer. Uh, you know, besides being a, a great operator and smart financially, it needs to be digital, digitally minded, uh, for how they solve these, these problems. So, um, lemme go through the, the, so solve the right problem. Go back to basics. Learn from retail.

Don't blindly emulate it. Don't neglect your people. Get buy-in. And then the, uh, fifth and final one is be humble. Change is hard, and they make the point that we're really new at this. We have a whole new set of tools, a whole new set of things that we, uh, you know, we, we don't have a lot of experience with.

We haven't utilized, we're going outside the industry. We're bringing people in. They're teaching us how to utilize the tools and we're teaching them, uh, healthcare and what goes on in healthcare. And so there's . There's an awful lot of things that, that, uh, give and take that are gonna happen there. And I think that's gonna be, uh, that, that's a good point.

To be hum. Humble change is hard and it takes some time. So one of this is, you know, engaged health consumers has gotten, uh, engaging health consumers has really gotten a black eye because it hasn't delivered on these unrealistic, unrealistic expectations that we have set. Um, however, it's still the future of healthcare and we have to be really good at it.

They, the, the, the people, the, the patients and the consumers of health make 90, 90, 90 9% of their health decisions when they're not in front of us, they're not in front of a doctor, they're not within our, the four walls of our health system. And until we can figure out how to influence those decisions remotely and uh, through digital means, health is gonna remain elusive.

And, uh, that's our fourth and final story in under 20 minutes or less this Friday. Uh, don't forget to catch, uh, part two of the show with Andrew, Dr. Andrew Rosenberg of Michigan Medicine on experience. Uh, you, you can also check out part one on the, uh, internal consumer experience as well. Every Tuesday, again, we have Newsday, but every Friday we have influencers like Eric, I Blanca from Stanford, Charlie, low heed.

Uh, a blockchain entrepreneur and, uh, founder of Explorers, which sold to I B M. Uh, it's gonna be on shortly. Andy Crowder from Scripps is gonna be on Jeff Johnson from Banner and many others. Uh, you're also gonna wanna check out, this is episode number 93, so seven more episodes. We're planning a special hundredth episode bash, and I wish I could tell you what's gonna happen there.

I know we're gonna have multiple guests on, and we're gonna do a celebration of sorts. So you're gonna wanna check that out. If you want hear from someone else, uh, someone you want to have somebody on the show or have a story you want us to cover, just drop me a line at Bill at this week in health it.com and uh, we'll see what we can do.

This show is a production of this week in Health It. For more great content, you can check out our website. At this week in health it.com or the YouTube channel at this week in health it.com/video. Thanks for listening. That's all for now.