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September 29, 2020: Cyber threats, ransomware, the addictive nature of Facebook and the biggest tech retail disrupters in healthcare. Why isn’t big tech just swooping in and changing the industry? What makes the Microsoft healthcare plate different from Amazon or Google or even Apple? How will healthcare delivery change over the next 10 years? Is it all still local and will it remain that way? Or are you ready to go into other States to offer services? Is your strategy thought out before you advocate to bring down some of those barriers? Also can patients be trusted with their health data? Can they understand it? Will they use it correctly? Is there a support system that comes with it? 

Key Points:

  • Microsoft will continue to do well in healthcare because they are on the side of healthcare providers [00:06:05
  • We Chat is fast becoming the number one online healthcare destination in China [00:07:35
  • To become consumer centric, what will enable and empower the patient? [00:12:30
  • Only 44% of healthcare institutions met national cybersecurity standards in 2019 [00:14:20
  • Blackbaud Philanthropy Database Security Incident [00:19:20
  • Epic was taken offline for precautionary hacking reasons [00:21:35
  • Microsoft: Attackers Exploiting ‘ZeroLogon’ Windows Flaw [00:22:45
  • Beckers: 10 hospital execs predict the biggest tech retail disruptors to healthcare [00:26:45
  • We made Facebook as addictive as cigarettes on purpose [00:33:45

Stories:

Transcript

This transcription is provided by artificial intelligence. We believe in technology but understand that even the most intelligent robots can sometimes get speech recognition wrong.

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Welcome to This Weekend Health. It's Tuesday News Day where we look at the news, which will impact health it. Today we are going to look at a bunch of things. We're gonna look at the stories we posted out on LinkedIn. We're gonna look at security. We're gonna look at the addictive nature of Facebook and other things.

We're gonna look at some quotes from industry leaders around where disruption's gonna come from and. Uh, a couple of quotes from Matthew Cole, the CIO at Cleveland Clinic, which I thought were insightful and, uh, interesting and I'm looking forward to sharing 'em with you. 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 19 series has been sponsored by Sirius Healthcare. Now that we're exiting the series. Stepped out to be a weekly sponsor of the show and they will be through the end of the year.

Special thanks to Sirius for supporting the show's efforts during the crisis and beyond. Uh, if you haven't signed up for three X Drex yet, you are missing out. Text Drex, DREX to 4 8 4 8 4 8. Receive three texts three times a week from Drex on the stories that he thinks are most important. Now, it's limited because, you know, when you text somebody, you can only have so many characters, so you're gonna get three or four stories that

That Drex is monitoring in his feed that he thinks are gonna be helpful. It helps me prepare for the show and, uh, it's a wonderful service. It's a service of Drex de Ford who's a frequent contributor of the show. All right, let's get to the news. We're gonna start with, actually, we're, here's what we're gonna do.

We're gonna go to our LinkedIn conversations. As you guys remember, I post a story every weekday on LinkedIn and invite you into the conversation and . And, and really conversations have been great and I'm really enjoying the, the back and forth with, with y'all. And here are some of the things I posted this week.

Should I go in reverse order? I'll go in reverse order. Here's what I posted on Monday yesterday. So why isn't big tech fixing healthcare again? This one hasn't had enough time to really, uh, simmer out there as we're recording on Monday for Tuesday show, but you know, . It was an interesting article. It was in the Washington Times, and the article talked about why isn't big tech just swooping in and changing healthcare like they swoop in and changed, uh, all the other industries that they have served.

And really what they talk about is the fact that the healthcare benefits don't accrue to the users of the technology. So. Of Amazon, the benefits of personal economic benefits accrue to me. But if I use Fitbit, Amazon, or, or Apple Watch or a Peloton, I get health benefits, but I don't get any healthcare economic benefits.

And when a, when a tech startup . Is trying to fund or they're trying to find some money or they're trying to get started, one of the first things they're asked is what your business model is. And these VCs are very savvy and they say you can either make money from the insurance company, you can make money from the employers, or you can make money from the health systems.

But if you're gonna go after the individuals, it can't be something that they expect to be covered by insurance. 'cause if they expect it to be covered by insurance, they're not gonna pay for it. So one of the things we're missing out on is that the benefits of these health technologies are not accruing to the masses.

So that's one of the challenges. And I, I thought what would be a more interesting title, to be honest with you, would be, uh, what does it take to unleash the power of technology in healthcare? Because there, it really does require a change in the economic model in order for that to happen. And the economic benefits have to accrue to me the individual who is making the choices, which impact my healthcare.

Do I eat at McDonald's today? Do I exercise today? And until those benefits accrue to me, this is the individual health is gonna continue to be, uh, really struggle and stagnated. And I think it's an economic problem. I don't think it's a technology problem. And the next question I asked was, what makes Microsoft's healthcare play different from Amazon or Google or even Apple?

And I think the, the major thing about Microsoft to understand is they have a huge healthcare play. As a healthcare CIOI had a huge budget that went to Microsoft every year, but it wasn't like Microsoft Health, it was just Microsoft. They, they just, it was my SQL servers, my, my storage, my servers. It was just proliferating.

It was the, the productivity suite. It's now teams and other things that are out there. All great tools for healthcare and a major part. But one of the things I think that makes Microsoft so good is that I believe they're an arms dealer and they know that they're an arms dealer. In other words, they provide the tools to anyone that wants to buy them.

They don't even care if you're competing with the health system across the street from you. They'll sell to both of you. They don't pick sides. They just sell . Access to a broad set of, of, of advanced capabilities. They also know not to get into the war. There's no talk of Microsoft going, getting into insurance, offering telehealth, hiring doctors.

When they came out with their telehealth announcements, which was over the last week and a half or two weeks or so, it was in partnership with health systems, in partnership with Epic integrated into Epic. And, and, and nuance and whatnot. It was not, Hey, we're offering telehealth or we're offering, uh, direct access to doctors.

Very interesting. I, I think that's one of the reasons that Microsoft will continue to do well in healthcare is 'cause they're providing, they're really on the side of healthcare providers and as long as healthcare providers do well, they're gonna continue to do well. Alright, next question. You know, how will healthcare delivery change over the next 10 years?

I thought this was an interesting article. The Chief Digital Officer for Mayo Clinic put out there, Rita Khan. She gave us a couple of windows into how she's thinking about it. A lot of stuff around home-based, remote patient monitoring, remote diagnostics. She believes that a lot of the technology's gonna enable us to rethink and reinvent the whole system.

Now, if we're just gonna . Tuck technology in, we're not gonna see the overall benefits. But if we are able to step back and rethink workflows and rethink processes and how they can be knitted together to, uh, better facilitate care, that is going to lead to something. So that was, that was an interesting conversation as well.

I thought this one was interesting. Is all healthcare still local? And will it remain that way? And the reason I highlighted this article, this was in the, uh, healthcare blog. Which is a good blog to, uh, follow by the way, Matthew, um, Holt's blog. A lot of, a lot of good things in there, a lot of things, uh, that are very specific to digital health.

So if that's not your game, then it's probably a little heavy on that side. But from time to time I pick up some really good things and this is one of those articles where I picked up some information on what's going on in China. So WeChat. Is according to CMI Media Fast becoming the number one online healthcare destination in China.

It offers, among other things, health content, uh, in some cases through partnerships with US firms, health products, telehealth, a network of trusted doctors, a form of health insurance, and we Doctor the Latter, provides online health inquiry services, psychological support prevention guidelines, and real-time pandemic reports, and is free to the user.

It is available 24 7 for people all over the world. What's interesting when I talk about telehealth, it's one of the things I say to, to providers and systems is, before you wanna bring down all the barriers and make Telehealth available across, across the, across your state and accessible for you and to other states, are you ready for that?

Are you ready to go into other states to offer those services, to pull those in? Do you have a defined strategy around that? Because I believe those barriers are gonna come down, but those barriers are gonna come down and then there's gonna be . Awfully large players coming into your markets who are going to be redirecting services.

So it's just something to consider. Is your strategy thought out before you are advocating for bringing down some of those barriers? One of the ones that got a fair amount of feedback, 34 comments on it. Can patients be trusted with their health data and can they understand it and will they use it correctly?

And this is, there was a survey commissioned by the Pew Charitable Trust that found the majority of the patients want easy access to their health data via applications, which we know this is not, not really rocket science. And it's interesting where the comments went, 37 likes or whatever. There's a lot of different options now and there's six different options.

You could applaud it, you can like it, you could think it's a good idea. Anyway, 37 of those and then 34 comments and, uh, some of 'em are interesting. Somebody who's, uh, a Department of Podiatry, medicine and surgery commented, uh, no, they shouldn't have access. They will won't be able to read it correctly, and it will trigger an avalanche of calls to the physicians.

For explanation and to a certain extent, I, I, I hear that and I understand that, and I agree with the aspect that we should not, one of the things we have to take into consideration is the unintended consequences. So we, we provide the, the information to the patient, which I think we all agree. It's the patient's information.

In order to activate the patient, to engage the patient, they're gonna need to have access to their information. And, but at the same time, we do not want . Doctors to be tech support. It's a poor use of their time. It's under way, under their license and it's not something that they should be doing. And so we have to be thinking through the, uh, the mechanisms that we need to put in place to make sure that the physicians aren't, that we're gonna do open notes.

Great. How are they gonna get information? Is there a support line? Is there now a service desk where they can call and get information on ? On their medical record information on how to use the portal effectively, information on how to do online scheduling correctly, that seems to be the number one.

Number one, let's say, you know, pushback on this whole concept of providing the patient, uh, patient information to the patient is that they don't know what to do with it. And I think one aspect is. Are you gonna provide a service where they can call in and talk to somebody, talk through their record, not necessarily their doctor, but just talk through their record with somebody.

Is this right? Does this make sense? Am I receiving the right care? Is there a better way for me to receive care? Is there a more cost effective way for me to receive care? This is the area I think that CVS is trying to step into where they're going to help you to navigate healthcare, and if they are able to get in between you and your patient, if you're a healthcare provider, uh, then you've lost the game.

I. Right, because now they control and direct the, uh, care to where they want to direct it to. And if they can help, if they essentially help me to understand how I can navigate it better, save me copay, save me actual dollars, give me a financial reward on that, then that is going to be a huge win, and they're going to be very effective at doing that.

Anyway, this post got a lot of, a lot of back and forth on it. I highly, I. I highly recommend you're looking at it. By the way, the, the other side of this is I, I love . What a condescending question. Can patients be trusted with their health? Data is my personal data and I should be able to do whatever I want with it.

And I think that's generally what we're hearing from patients. So if we're gonna become a consumer-centric type of industry and uh, organization, we're gonna have to think through. What it's gonna take to enable the patient, to empower the patient, to give them the information, but then also have the systems in place, the processes and the systems in place to provide them the services to understand their medical record, not necessarily the doctor doing that.

one-on-one, but also the the support to use the technology. Now, what a lot of people will tell me is I use Apple apps all the time. I never call tech support. They're just intuitive and easy to understand. And yes, uh, we should be striving for that level of, uh, user-centered design so that we are really designing it in a way that is intuitive to the end user.

And I would say we have to keep into consideration that a significant portion of our population, I. That utilizes our services are older, and I'm thinking of those phones with the big buttons and only four or five options. And I, I was commenting with somebody and I said, for seniors we should have that option for our portal.

Five buttons, five simple buttons that, that they do. And if you think about it, you break it down, what are they looking for? They need to refill the prescription. They need to text or talk to their doctor. They need to schedule an appointment. They need to, uh, check a result. There's five. You could think through what your senior population's looking for from a portal, and you should develop an app that has just five buttons.

Simple to navigate, not this, if you're providing the same app to a young invincible and a chronic. A chronic 80 year old then, then we've missed the mark I, there's very few applications that are going to be utilized and thought through the same way. Next thing I posted is leaving my data with a health system, leaving it with a bank that doesn't lock its vault.

And this was a result of a survey that said only 44% of healthcare institutions met national cybersecurity standards in 2019, according to an annual report from the consulting firm, Senator Eck. That's a slight drop of from 45%. But think about that. That's a, that's a drop from 45%. So we're at 44%.

That's a failing grade, right? A hundred percent being an A or an A plus 44% being an F. Maybe an F plus, but an F nonetheless. And I, I just think the case of. Is there another way to do this? And I've made this case something a couple times and I, it gets me interesting feedback from the audience and I, I welcome it.

Let's keep the conversation going. So I, I just, I pondered this thing. I wonder if there's a better way. How about a health system? The health system doesn't store my data, and I bring it with me when I seek service. I have a phone with access to the cloud that I can easily store my health record in. How about the health system?

Give me my entire record. When I present for care, I can provide my entire or a portion of my record for a period of time that I specify. And when I leave, I take that entire record with me. And then the question obviously comes up. What if I'm unconscious? We up break the glass. This is a common concept.

We use it with HIEs all the time today. What about and, and so I'll know you broke the glass in order to care for me. Great. Okay. And if, if you're caring for me, I'm gonna say, great. Check the box. That's good. I appreciate you breaking the glass in the, in my time of need. What about public health research?

And my comment to that is just ask, make the case for the work that you're doing is good and I'll give it to you. Better yet. You could pay me for it, but you don't have to pay me for it. 'cause if I feel compelled to give my information to the American Health Heart Institute or, or fill in the blank. If you make the case, I'll give my information to a ton of people to use for research.

If that's my bent and it is my bent, more institutions will probably have access to, or more researchers will probably have access to my, to my information than normally do today. And they would stop having to pay. Whatever entities they're paying to get that information today. And somebody also asked me in this about what about the, the people who can't afford phones.

And I, I, I was getting that question back in 2011 and the research would actually show that number is probably lower than you might think. However, my comment on that after thinking about it now for about nine years is if the government wants to fund something, they can fund cloud storage in a simple phone for the underprivileged.

And I, I know that brings chuckles from time to time. People are like, are you gonna give everybody a phone? And the answer is, I. , have you tried to live a week without your phone? Uh, or even a day for that matter? It's harder to function in our society than you might think without a phone. These days, payphones are gone.

Phone books are gone, maps are gone. Newspapers are no longer where you go to look for a job. How am I supposed to function in this society? There is a digital divide that gets created, but that digital divide leads to an economic divide, leads to an access to healthcare divide. And so you really do have to address the

the digital divide if you're going to do anything in healthcare. Alright, that's probably enough of those. You can go out and read those. Uh, in fact I would strongly encourage you to that. Those are on my personal LinkedIn, so if you wanna follow me, bill j Russell out on LinkedIn. I'm gonna continue to post one a day and really enjoying the back and forth with you guys.

Some of it. We get some interesting troll comments from people who are, uh, not fans of what we are doing in healthcare, which is, which is good. It, it gives us the other opinions that are going on there so that we can stay, uh, current on those. I. Don't forget also to follow the show on LinkedIn as well. Uh, uh, the show is at this week.

It is this week in health It out there, and you'll get the posts on all the stuff we're doing, like the show or the industry influencer shows or the, uh, solution showcase shows that we do. Uh, so you'll keep current on all those things. Plus we're posting those, uh, short clips. Out on the, this week in health it, uh, show as well.

So if you like those short clips where I take the, uh, two, one to three minute segments on the, uh, interviews, uh, that's a great way to get those as well. Plus you can sign up for clip notes. That's the other way to get those. All right. Now let's just head over to my feed. We'll get to, uh, a few more stories.

What time is it? 20 minutes in. All right. I will try to, I, I'll try to close this out. In, uh, another 10 minutes, and I may post some of these stories this week. Uh, security is top of mind today. I've received a couple phone calls and, and talked to some people over the weekend and looking at some things.

First is, obviously there's been a bunch of security activity. There's the, the Black Blackbaud incident, which has been out there for a little while. A bunch of healthcare systems. It's have been hit by this. Let's see if I can open something up here. And one of 'em is Atrium Health. A Atrium alerts patients of ransomware data breach on one of its hospital vendors.

So these are BA, a covered systems. There's, uh, it really wasn't access to the medical record per se. So in recent weeks affected patients and philanthropic donors were notified by Atrium. Posted a notice of the ransomware attack on its website, atrium Health Officials said the notice. In the notice of information, possibly including a person's name, birthdate, and doctor's name was accessed by cyber criminals targeting one of its vendors, block blood.

The hospital system says no medical records or information about the medications or test results were compromised. Yeah, this is a separate system. It provides donor management software for many institutions and I think there's another story over here and, and it did hit a bunch of healthcare solutions.

This is one of those, again, they, a lot of health systems have. Charitable arms, they're raising money. They keep track of those donors. Blackbaud was a significant piece of software for a lot of organizations to utilize. Let's see, Blackbaud, there we go. I. Some other Guthrie was compromised as well. Uh, I'm not seeing any others in this right now, but I I, I'm pretty sure there's some others that have been compromised.

Another thing on the, uh, security front, Equinix discloses ransomware attacks. So e if you don't know data, Equinix is one of the large data center providers in the country and they, they were attacked as well with, uh, ransomware. They said they responded very quickly and got in front of that. I. But I wouldn't, uh, be surprised if there's some healthcare organizations that were, uh, impacted by that.

I don't know those specifically. Nebraska Medicine has been down for several days, and I watched a local report on that and it's believed that it was a cyber attack. The news story that I read reported that Epic was taken offline and had been offline for a couple days, so users were not getting their test results and other things.

I don't know if Epic was taken offline in a precautionary or if Epic itself was down. My guess is it was taken off for precautionary reasons. If they were compromised by ransomware, they probably wanna make sure that critical system doesn't get attacked. So Microsoft Attacks have actually escalated in since September, and we're seeing that, we're hearing that.

And so I, I sent a note to . Two directs to Ford mentioned earlier, a friend who does a lot of work in cybersecurity and he shot me over this, uh, great article in on the website. Dark Reading is a, uh, site dedicated to, uh, security and security issues. Lemme see if I can blow this up a little bit. I am wearing glasses today.

I am doing a lot of reading. . And, and I'm getting older. My birthday's this month, so getting older, lot of reading glasses become mandatory. So here we go. Six things to know about Microsoft. Zero login flaw. By the way, this is a big one, right? And Microsoft made us aware of this thing in August. I. And, uh, activity has picked up since Microsoft has released it's patched.

So this is one of the things that happens. So Microsoft says in August, Hey, we've got this big flaw and we're gonna release patch. So they release the patch. When the patch is released, it's . Signals to people, Hey, here's what we're actually patching in a system. So the hackers go to work, they get the patch.

They know that you're not gonna patch as quickly as they're gonna look at the information. So they look at it and they say, oh, here's what this thing actually is about, and they start to generate payloads. Well, those payload payloads start to getting delivered in September. Let's talk about what it is.

So net log on zero login, our log on vulnerability. Is an elevation of privilege vulnerability that exists in MS. NRPC. Uh, net log on a core authentication component of Microsoft Active Directory. This is why this is a big deal. Net logon is a service provided by the domain controllers to give secure channel between the computer and the domain controller, so it normally requires previously established credentials or other authentication methods In order to, for the channel to be used, the net logon, zero logon flaw has been assigned A-C-V-S-S base score of 10, which is the maximum possible severity rating for a software flaw under a widely used vulnerability scoring system.

Why is there so much concern? The net log on zero log on flaw allows an unthought unauthenticated attacker to use MS NRPC remote procedure call to create a domain controller and gain full administrator access to Microsoft Services. Okay, so that's domain level , that's domain level access at your, at your domain controller, which means more than likely, depending on your architecture.

It is going to be, give them access to your entire networks ag again, uh, take a look at this. Keep a close eye on this and lemme tell you that the so what on this is,

is, is, is pretty obvious. You know, we were busy during covid, but the, the cyber threats didn't stop and they didn't stop advancing. And the main thing is vigilance is key, so you have to make sure everything is patched, patched, make sure remote workers aren't bringing in payloads, which can compromise your system, which is, by the way, the most used me mechanism or attack mechanism at this point is just deliver the payload through email

and . Make sure that you have a way to restore systems in the event of a ransomware attack. Uh, we, we touched on this on one of the shows, one of the first things they look for is your backup files. If they find your backup files, they will compromise your backup files first, and then they will lock down your stuff with ransomware.

These people are smart. They're not, they're . These are, in some cases, these are nation state attacks and these are highly sophisticated attacks, and if they're not nation state attacks, they're crime families. They're. Organized, they're organized. Crime families is probably not the right word, but they're organized, uh, crime syndicates that are looking to make money.

And this is one of the ways that they have, I identified to extract money from the healthcare system. So vigilance is key. This is gonna continue to be a very important topic. So if you haven't patched, look that up today. Make sure that you are patched across the board. That will give them access to, gosh, just about everything.

That'll be the keys to the kingdom. I think three quick hits, uh, to close. Let's see. Yeah, three quick hits to close comments from industry leaders. I found this one interesting.

So Beckers went out and asked 10 hospital executives. , uh, from Amazon and Google to Walmart and CVS. Retail giants are transforming the healthcare industry and fueling new needs for innovation here. 10. Chief innovation and digital officers from health and uh, hospitals and healthcare systems across the US share their predictions of what companies will become the biggest tech and retail disruptors to healthcare.

And again, we talk about this topic a fair amount and. Let's see, who do I want to quote? Daniel Durand, md, chief Innovation Officer for LifeBridge Health. I think there's a difference between what the intention of the different groups is versus what they seem to be achieving in real time, but I would put my money on Amazon.

Amazon gets a lot of, uh, kudos here. So Owen aan, chief Digital and Chief Data and Digital Officer Atrium, Amazon, and Walmart. However, best Buy and Comcast can disrupt. In a major way as well. Uh, I would agree with that list, by the way. Uh, not necessarily in that order. I think Walmart's gonna be the biggest, uh, disruptor.

Probably first just because they've been methodically moving in this direction and are getting ready to ramp up. Amazon will be a disruptor. don't hear me. Not saying that. I just think Walmart will get there a little quicker. Best Buy. We have noted several times on this show. I believe it's gonna be a huge one.

Elisa Pade. Chief Innovation Officer, Henry Ford Health System. Apple, let's see. Aaron Martin. I think it's going to be a tie with different markets. In the millennial commercial market. It'll probably be Amazon, and in the Medicare market it'll probably be Walmart. Uh, yeah, that's probably a good distinction.

I would agree with that distinction. Good distinction to make between the different markets. Peter Fleisch, doctors. New York Presbyterian Chief Transformation Officer. I think Microsoft has a pretty, uh, impressive technology giant, and the work takes on it is pretty impressive. I agree. We've talked about that earlier.

Uh, and a couple more here. Amazon, Optum, CVS, Amazon, Google. Actually, there's only one Google that's interesting to me. Only one Google on the list. That might be an oversight, but anyway. . What's the so what on this? Keep your eye out for your potential competitors. They're not all gonna be the same, just because somebody you respect out there says, Hey, it's gonna be Walmart, or it's gonna be Amazon.

Or think about the different markets. Think about the markets you serve. Think about the, the people that are already in your market. Think about who you are patients and who your con consumers are already interacting with. Those are your potential. The the people, you're not gonna have time to respond to.

So if they're already going to Walmart on a re regular basis and Walmart really comes through with an insurance product and a new clinic and whatnot, it's gonna be, you're gonna be hard pressed to respond to that. 'cause that's gonna happen very quickly. It's gonna be six months. You have to respond. But if somebody has to come in and actually establish a market, uh, you're gonna have a little bit more time to respond and come back with, if somebody comes in with telehealth.

And you have no Telehealth competitors today and they don't really have a market for you, and they come in and they're gonna cut, undercut your prices and whatnot. You can actually do a pricing strategy to thwart that a little bit and then fill in the things that you need to do. So again, I'm just saying everybody's going to be looking at a little different landscape.

Matthew call, let's see, I wanna pull that one up. Five quotes from Cleveland Clinics. Uh, again, Becker's. Uh, so I think what Becker's does, actually, I know this was what Becker's does, uh, they send emails to these people who are extremely busy and they say, Hey, uh, let's do an email interview. Here's five questions I'd love for you to answer.

And they go ahead and answer them in whatever timeframe that they're able to do that. It's actually a pretty good method. I might, uh, start to employ that next year. We'll see if that makes sense. Uh, here's five quotes from Matthew call on digital transformation. I'm not gonna share all of them. On Cleveland Clinic's digital transformation management.

From a digital perspective, honing in our telemedicine and telehealth, especially as it's becoming more accepted as a care pathway, is job number one. I think that's a, that's important. I, what I like about that is they've really identified, this is job number one. This is the most important. We're gonna try to figure out how to leverage this delivery vehicle to the, to its, uh, maximum, uh, potential.

His advice to tech leaders don't under, under underestimate the amount of research that your physicians and other administrators or even your nursing staff are doing and into some of these advanced technologies. When I get a call out of the blue that says, Hey Matt, I want to talk to you about deep data mining technology.

When can we sit down? And have that conversation three year ago, three years ago. I would've never have thought of that happening. It's, it was just not that common. Uh, I, I love that, uh, comment. I think that's true. I think we are seeing physicians more and more, uh, physicians and nurses doing their research, coming back with well thought out technology plays and well thought out data plays,

And, and they wanna be a part of, of co-creating the future, the technology future. So you have to figure out how to bring them in as co-creators. That's a so what on that, on new avenues for innovation. Technology is ubiquitous everywhere, and I think we're gonna start seeing a lot of innovation occurring much closer to the edge.

I agree with them on that. The edge is where a lot of things are going to start happening. You're gonna see processing happening at the edge. You're gonna see. A lot of devices at the Edge, obviously is, is starting to proliferate on organizing cloud capabilities. I think that defining your cloud strategy and providing a curated list of services is really good way to tighten that innovation framework and that when great ideas happen on the edge, they become interoperable with the things that are happening in potentially other divisions.

In fact, that's the way I would think about the cloud. The cloud is your platform for bringing all these disparate edge strategies together. The cloud should have a platform. There should be it. It doesn't have to be a platform, but it has to be a well thought out set of technologies that interop, interoperate well.

So that as you do these different things on the edge, you can bring that data together, you can bring that information, you can make it flow, you can create workflows across it and, uh, enable your organization. Uh, he goes on to say some good stuff. I, Matthew has . Uh, a lot of great insights here. I agreed with four outta the first five, and I didn't even read the fifth one.

I'm sure I agree with that as well. So, uh, great insights from him. Really appreciate it. I'm gonna close with this last one, which I think is just interesting. I think it's, I think the intention of this is to trash an old company, but former employee, we made Facebook as addictive as cigarettes on purpose.

Tobacco companies initially just saw it to make nicotine more potent, he said, but eventually, that wasn't enough to grow the business as fast as they wanted. And so they added sugar and not methanol, menthol to cigarettes so you could hold the smoke in your lungs for longer periods. And at Facebook we added status updates, photo tagging and likes, which made status and reputation primary and laid the groundwork for a teenage mental health crisis.

I, the reason I close on this story, I not, the reason I close on it, I didn't plan to close on it, but the reason I'm talking about this story is there's an all, we talk about the gamification of healthcare. One of the things that happens when you open Facebook is it's, it releases dopamine. Do have people tag my stuff, have people like my stuff.

It's one of the things I hate the most about my job and being out on social media. It requires me to be on social media and it is an addictive platform. Did they like me? Did they follow my story? Did they comment on my story? All those things are releasing dopamine in your system whether you want to or not.

Whether you are a, you know, 53 year old sophisticated person who even knows what they're doing to you. It's still doing that. That same thing can be released in, in how we think about healthcare. Why not ? Let's make health addictive, let's make, uh, things that people do addictive. That is eating well, that is exercising, that is conversing with family members, that is making friends, that is being social.

All the things for mental health, for physical health. Let's make that addictive. Let's think through it in the same way that we can make people hooked on those kinds of things. And I know a lot of people are thinking that way, and, uh, I think that is a. Uh, a, a good way to be thinking, heck, it's being used to make me eat.

Eat more ice cream. Let's start to use it to make me exercise more. I think that would be great. That's all for this week. Don't forget to sign up for clip notes. You'll get an email with, uh, short clips from each one of our episodes. Great way to share it with your peers and share it with other people in your organization.

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