This Week Health

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March 29, 2021: Frank Nydam, the VP of Healthcare at VMware joins Bill for the news. The CHIME Spring Forum is coming up. Future Vision for Health & Care: What’s Coming Over the Horizon? Post-COVID Trends Shaping Healthcare. Putting Patient Experience at the Heart of Healthcare. What goes into the planning of virtual events like this? And what is the future of these kinds of conferences? What is all the hype around the concierge medicine startup Transcarent? How should health systems be preparing for the future of hospital at home? Have consumer habits changed enough that we're going to see a shift in how care is delivered post Covid? Microsoft did a study on people working remotely. Are they thriving or surviving? Big companies are wrestling with their hybrid work plans. 

Key Points:

  • With Transcarent, Glen Tullman and General Catalyst’s Hemant Taneja are applying the Livongo playbook to the employer-sponsored healthcare system [00:14:05
  • The big winner of really moving forward is behavioral health and mental health via telehealth [00:25:55]
  • A Microsoft study finds 41% of workers may quit this year. The big complaint is being overworked. [00:28:55
  • A mix of office and remote work brings new hurdles [00:32:35]
  • The hybrid work model opens you up to a new diverse set of talent [00:33:15]
  • Transcarent 
  • VMware 
Transcript

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

 Welcome to this Week in Health It, it's Newsday. My name is Bill Russell, former Healthcare CIO for a 16 hospital system and creator of this week in Health IT at channel dedicated to keeping Health IT staff current and engaged. Special thanks to Sirius Healthcare Health Lyrics and Worldwide Technology, who are our new state show sponsors for investing in our mission to develop the next generation of health IT leaders.

We set a goal for our show and one of those goals for this year is to grow our YouTube followers. Uh, we have about 600 plus. Followers today on our YouTube channel. Why you might ask because not only do we produce this show in video format, but we also produce four short video clips from each show that we do.

If you subscribe, you'll be notified when they go live. We produce, produce those clips just for you, the busy health IT professionals. So go ahead and check that out. Common question I get is how do we determine who comes on this week in health it, to be honest, it started organically, it was just me inviting my peer network and after each show I'd ask them, is there anyone

One else I should talk to. And then the group, obviously the network group, larger and larger, and it helped us to expand our community of thought leaders and practitioners who could just share their, their wisdom and and expertise with the community. But another way is that we receive emails from you saying, Hey, cover this topic.

Have this person on the show. And we really appreciate those submissions as well. You can go ahead and shoot an email to hello at this week in health it.com and we'll go to the, to the entire team. We'll take a look at it, reach out to these people and, uh, see if there's a good fit to, to bring their knowledge and wisdom to the community as well.

Uh, we also launched today in Health It a weekday daily show that is on today in health it.com. We look at one story each day and try to keep it to about 10 minutes or less. So it's really digestible. This is a great way for you to stay current. It's a great way for your team to stay current. In fact, if I were ACIO today, uh, I would have all my staff listening to today in health it so we could discuss it, you know, agree with the content, disagree with the content.

It is still a great way to get the conversation started, so check that out as well. Now on to today's show. Today we are joined by Frank Knight, the VP of Global Healthcare at VMware, and the winner of the referral program for CliffNotes last fall. And Frank, welcome to the show. Oh, thanks for having me.

Long time listener, , I just have to start by thanking you. We, we launched the Clips program in the, in the fall, which is the, the email distribution list where 24 hours after you, after we do a show, do you get an email? It has the summary, has bullet points, then has the four video clips with it, and now send out close 18 emails.

Appreciate all the referrals that, that you gave to the, to the program. So I just wanted to give you a, a big thank you from, for being the team for that. You're, you're welcome. This is always been a big supporter of what you're doing and, you know, we as a IT partner vendor, we always gotta, always looking for more information about what's on the bind of the healthcare CIOs and your, your service and your information is always great, so I appreciate it.

Well, thanks. Uh, well, thanks for coming on the show. You do, do you do a lot of these, do you do a lot of podcasts and that kind of stuff? Or, or is this this pretty rare for you? No, we used to do, uh, I used to do many more, so not, not too much. I was looking forward to this. It's been a long time. It's, I think, we're, I've been stuck in my basement so long.

It's nice. Uh, I, I, I'd love your basement For those listening on the podcast, you're gonna have, check out the video. You got the, you have the multiple guitars going and any stories behind the guitars. You actually, you, you play pretty extensively. I, I do it. It is funny how Covid and Zoom has introduced me to so many other people that play instruments, especially guitars.

I see guitars hanging on the wall and some of 'em are decoration, but like to say, I use 'em, uh, it was a thing. We picked up a, I picked up a college a long time ago and. I'm over 50 and we've got the over 50 band that plays at my garage and some pubs. Uh, looking forward to getting back out. Uh, you know, we, we can put together a, a health IT band that plays at the Chime event.

So anyone, uh, so you'd be the, uh, guitar player and we just need to find, you know, a a, a bass, a, uh, drummer. I, who, who do you think would be the best CIO lead singer. That you can think of, uh, Aaron Mur, , Aaron Mur as the lead singer, and we'll have to come up with a name later. I, I can't imagine, and I don't wanna offend anyone, so I'm gonna be careful here.

Alright, let's, let's go ahead and step into this. We are gonna talk about the news, but before we do that, you were a part of the planning committee for the upcoming Chime conference is. Yes, that's correct. I, I was. All right. So this, I I, I'm gonna hit you up for some, uh, insider information here. We're, we're gonna cover the agenda.

This is, uh, this is an Allstar cast, a lot of former guests of this week in health. It, but it's a, it's a phenomenal set of speakers. You know, what, what can you, what can you tell us about, about the planning process for this? I, I think it goes without saying. We, we all miss getting together and that was probably the, the best thing and it still is the best thing about Chime the fall form, the spring form, seeing everybody shaking hands.

And I know John Kravitz, uh, and Darren de work and the committee really wanted to do something completely different this year. And you know, I think we're all Zoom fatigue. So, you know, we just got an all-star, uh, cast. I mean from, from the opening, having Cerner, epic, uh, and Meditech on stage together. I think we've all sort of been waiting for that for a long, long time.

And I mean, some of the folks on the other panels, the big tech speaking, Amazon, Microsoft, and Google. So just wanted to completely rewrite the script of what, uh, chime spring form is going to be. And again, since it is virtual. Uh, this is gonna draw a lot of people. I think we're gonna have a really good conversation.

Many great conversations. Yeah. So I, I imagine there's a lot, you, you wanna draw people back, but you also want to create that, that experience. But one of the things we like about the spring and fall forums is we get to, you know, rub shoulders with each other and have conversations and just catch up and those kind things be that kind of environment with setting.

Uh, there, there's been a lot of attention to that. There's some suites there where you can get together and have outside conversations on questions from the audience, pre, pre three questions. So I think it, it will be good. Again, there's only so much you can do on Zoom, and that's why we really wanted to focus on.

These great leaders. All right, well let's, let's, let's hit some of these. You know, the opening keynote panel should be very interesting. You have Judy Faulkner, Howard Messing, Judy, CEO of Epic, CEO of Meditech, Howard Messing, and CEO of Cerner, rent Schafer with Darren Dorchen as the moderator. That's.

That's an all-star panel. I'm not sure I've, I've seen that group on a stage together before. You know, the, what's the topic? Future vision for health and care, what's coming over the horizon? I guess this will be from an EHR provider perspective. What's, what's coming over the horizon. That's a good way to start this thing out.

That's a, that's pretty impressive. Behind. The three big tech leaders, public cloud, uh, behind that, that should be even more interesting. I think. Uh, they build upon each other for sure. Yeah. So you have, yeah, Google, Microsoft and AWS You have Phoebe Yang, David Ru, Dr. David Ru, and Ashima Gupta, who with, with Google, with Daniel leading that conversation.

Again, this, this is some great, uh, some great panels. And then in the afternoon you have post Covid trends shaping healthcare. You have Helen Waters with Meditech leading a conversation with Razu, with Atrium Razu. He's, he's almost like Cher. You just have to say Razu and everybody knows who you're talking about.

Jim Noga with Mass General and Theresa Meadows. And again, another phenomenal panel. And I, I'm, I'm not, I'm gonna slide some of these other, we're not gonna go into all, but there's again, Rosenberg, you have, uh, Joel Vanko Edwards, all former guests. I highly recommend people sign up for this. It looks like it's gonna be a, uh, phenomenal discussion.

So that's the, what is it, three days, two and a half days? Yeah. I, I, I tell you, we, once some of these folks started signing up and the, the vision that, uh, John and Darren and team put together, we were really excited about this. It's coming to get great. Yeah. So should be good. The, just outta curiosity, what do you think the future of these kinds of conferences are?

Do you think we'll get back together soon and do you think, we'll, we'll hold on to some of this virtual moving forward to, to make it accessible? I, I think the, the human part of us wants to come out and shake hands again and see people. Yeah. So absolutely. I think we'll all be getting back together when, who knows?

I think there's a lot of, everybody keeps calling me saying, are you going to hims? Will you be there? I'm going, I'm not going. So yes, I think there's a deep desire out there. But on the, on the other side, I think the virtual, the virtual platform allows you to connect to a lot of folks that you wouldn't have connected to.

I think it's an interesting byproduct that we're seeing from our marketing and outreach team. From a VMware perspective is where we used to see, you know, maybe a thousand people we're getting, you know, 10,000 people seeing this. So it had its drawbacks as well, but . I, I, I miss seeing people. I, I know you miss seeing people, and that is, that was always what drove us to chime and continues, uh, to drive us to chime with that interaction.

I think that's how you and I first met. Yeah. Yeah, absolutely. The, the HIMSS conference is, is it July, is that right? You know what, I'm not sure the date is of that, uh, bill.

Is the, the, the timeframe that we're all gonna get back together. It feels like it's if, if, if it's going to happen, it'll be just, just over the, the, the line where we feel like, alright, it's safe to go back into the water, but because it's on that edge, I think everybody has that question of is it too early to be doing this?

I know that. In San Diego, they're, they're planning on doing that live, but that's, that's like October timeframe. Right, right. But I, you know, I think, I think this whole conference industry sort of needed the shakeup. It was getting sort of repetitive. You, you knew when these things were happening and. You know, I, I think the, the virtual piece has actually helped it a, a little bit.

I think we need that human interaction, but every once in a while you need to shake, uh, shake the snow globe and see what comes down of it. I think, uh, it'll, we'll this, so, so the pandemic was shaking the snow globe on the conference industry, and I, I agree with you. It kind of stale. The, the, you know, the conferences, some of the conferences were sort of petering out.

Some were, you know, still thriving on history really, for the most part. So, we'll see. We'll see how this whole thing shakes out. I don't, I don't, I don't suppose I'm gonna get you to say anything, you know, really controversial here about the.

No, you know, I will say there's, uh, like I said, maybe the Snow Globe piece, the HLTH conference and their organizers have, uh, been great. I think they're thinking outside the box, uh, bringing a lot of startups and we participated for a couple years, I think last year. I mean, Judy spoke at that as well. So we had a lot of government representatives.

Uh, that's another one. I think it's a, it's a great output of this. Well, the thing they, they've been able to do at that conference is they're bringing not only healthcare providers, they're bringing pharma, they're bringing, uh, big tech. They're bringing the insurance plays. I mean, they, they're literally bringing the whole ecosystem together to.

To really have conversations around what we can do to, to move healthcare forward. And I think that's their, that's really their, their strength. And if I, if I look back the, I went to the first one and the second one, I think those were the only two that were live. But the first one I went to, I think I was one of only maybe three or CIOs that I can remember being there.

Yeah. And you know, healthcare wasn't really well represented from a, from an IT perspective. Healthcare was better represented only because they had a whole bunch of CEOs and leaders from healthcare up on the stage. You know, that's the, the last time I heard Bernard Tyson speak. And he gave a phenomenal talk and I, I think he died like just a month or two after I felt old at that first H-L-T-H-I-I was walking around.

Uh, it was a lot of startups, which is really interesting. I think they had a, I remember they had a nice shark tank type of type of thing on stage and pitching their ideas and it was. You know, that, that's still excites me about healthcare is, you know, what are they thinking about in the proverbial virtual garage.

You know, there's some outlandish ideas out there, but, uh, maybe it's, it's the snow globe analogy as well. All right, well, let's let, let's go into one of those startups and it's probably the, the loudest startup in quite some time, and that's transparent. So transparent is Glen Tolman and Teams. I don't wanna slight any of his team members because it seems like Glen's pulling a bunch of the, uh, former Livongo people over and former Allscripts people over.

And you know, transparent is an interesting model. They are essentially going into the employer space, into the self funded employer program, and. Around care delivery, and it's really interesting. It's technology play, so they provide information, but it's also a connection play and an experience play in that not only do they, they wrap the technology around it, but they will connect you with care.

They will follow up with care, and their financial model is very different from anything we've seen before. They are essentially gonna baseline an employer's current cost for their program and they are going to take a percentage of the savings over and above what they're able to save them. And because they understand healthcare so well, they are going to be able to do some things I think that are interesting to drive costs out of the equation.

The redundant testing inefficiencies that naturally in healthcare is interesting. They're after. That's a, a fairly lucrative space. So you, have you gotten a chance to take a look at France current yet and, and what they're doing? You know, what a, a little bit I, that whole space fascinates me. I was ac actually having a conversation with my wife about, uh, um, this in preparation for this.

Oh. We were chatting about, you know, her experiences recently in the healthcare system and you know how we all sort of walk. It's always the gaps, right. The providers do a really good job here. The payers do a really good job here. It's, but it's those gaps. It's the handoff, it's the patient experience, consumer experience.

It's the, geez, I just had my annual physical yesterday and I still, my, my cardiology report still isn't getting over to my primary care physician. So I, I would say they're doing a good job in attacking those gaps between all these places. Between all these. Whether it be the technology, the payers, the providers, the, uh, you know, everything.

And I think that's where they're doing a really good job. It's, it's interesting to me because if we just talk through the experience, and this is when people say healthcare is broken, this is what they're referring to. They're not saying, Hey, I don't like my physician and I don't like my hospital, and I don't like, you know, the care that I receive.

Generally, they're not talking about those things. What they're talking about is, look, I have to pick an insurance provider. I don't know who's in that program. And this is where transparency sort of steps in. They, they step in for that employer to say, look, your benefits meeting was contentious last year and the year before and the year before that.

And every year you have to tell your employees the costs are going up. Alright, so let's address that. Let's make the, the process of getting people onboarded a lot easier. And then when they need care. They can have access to somebody from Transparent seven by 24, 365, within 60 seconds of their question sort of arising in their head.

And then you have that person who's gonna help them to figure out where they should go and, and how they should, uh, proceed with care. And that's, you know, when my wife was making a lot, and we know this, that the, the mom generally makes a lot of care decision making. She was constantly telling me how awful my insurance, and she wasn't.

As a result of having a, a payer over here, a provider over here and APBM over here, and not having the whole thing orchestrated was awful for her. She didn't, she didn't know where to go. She didn't know where the bills were gonna come from. Uh, she just didn't know how to navigate it. And then, god forbid she'd have to see a specialist and then, you know, a of.

Interesting play. I, I'm really looking forward to seeing where they go. You know, the, the other thing from a success standpoint, Glen Tolman did Livongo and that team did Livongo, and they did a great job in the initial IPO and they did a great job in the exit. So, and, and they've done a good job already with transparent raising money, so they have money.

Leadership team. It's a, it's a healthcare leadership team. Yeah. So they, they really understand healthcare. I mean, this thing has a lot of positives going into their launch here, and it, it will be interesting to, uh, keep an eye on this one. And I, I hope they're successful. It, it will be. And I, you know, I think the other interesting, uh, thing here is as they attack those gaps, attack the generational gaps.

And could you bring a good point? Uh, usually wife's moms. The leader of the household are dealing with these things. But recently, my, my college age daughter, she's a senior, had an emergency appendectomy and watching her go through that, now they've got great care, what have you. It's just again, bridging the gaps.

Where do I go? Can I see this doctor after? And you know, it's a little different for the parents, but now you look at that next generation who expects everything at their fingertips. Amazon easy. And it was interesting watching her go through this process. So I think, uh, folks like Glen's company is going to, if they, if they focus on that generation, their next, their next consumer, they're gonna do well.

I. Yeah, it's that next generation is like, well, let me get this straight. I have to do this, I have to do this. Can I just find somewhere where I can just buy it? Can I just do a, a telehealth visit? And it's like, yeah, yeah. But it's included in your insurance. Yeah. Yeah. I'll give you my credit card. Let's just, you, I, I don't wanna navigate that.

Let's just get to that Very true. Cut to the chase. Alright. How have you experienced healthcare during the pandemic? Have you, have you done the, the telehealth visits and those things? I have, I have had to do one. Uh, my wife has, has done a couple. I will say that, uh, we've been fortunate enough to get called up for our first vaccine and I was just a amazed on how smooth that was.

I was predicting chaos. They had turned a local mall here into a super vaccine site, lot of national guardmen, which I found interesting, all walking around their, their, uh, cart on wheels, . Entering this stuff into Epic and it was, uh, it went much smoother than I thought it was gonna be. Was was it run by a health system or was it run by Yeah, it was Atlantic Health here in New Jersey.

Okay. Yeah. That's interesting. The, uh, yeah, my, the people I've talked to, the experience in getting the vaccine has been, has been pretty good. The gentleman in Arizona was telling me he was in and out within like 15, 15, 16 minutes. In Glendale, Arizona, and you know, in my experience, and so in Florida, it's finally come to an age that I can, I can get lined up and someone reached out to me, which is crazy.

I got an email saying, Hey, we have vaccine, we're ready if you want to schedule your appointment. And, you know, it's a reputable, you know, reputable player. So I, I, you know, reached out and they're.

The Moderna vaccine and, you know, away we go. I'm, you know, I, I think we've, we've worked through a lot of the, let's just say, uh, the learning curve of how to do this effectively. Yeah. We got a QR code and we're ready to go, but. You know, I, I, I think one, one of the things that we, we have been thinking about at my company is, you know, this, this, the have and have nots, though it's still amazing where, you know, you know, big company, you know, contacts and we're, you know, unfortunately have a, where health issue getting in there, but.

You wonder sometimes what's happening in the, uh, other parts of the country. You know, I live in a, you know, 45 minutes outside of New York City. You're in a big area. I'm worried about those rural communities, and I think that's one of the things I'm excited to focus on, and I think as an industry we should focus on is that patient equity.

There's a little bit still too much of the have and have not. Yep. No, I, I agree with that. Especially between the urban and rural that exists. Then you have the homeless population and whatnot. I, I think the, you know, the homeless population, those who are disinfected in the cities, it, it really is on the health systems to reach out to 'em and, and in a partnership with the, with the agencies in the area, first of all, to find them and identify vaccines, the.

The, the rural health systems couldn't handle the Pfizer vaccine. It's just not, it's not feasible. Yeah. And so that, that cut them down to just, just working with the Moderna vaccine. Well, now we have, you know, the JJ vaccine and we have the AstraZeneca, I think is gonna come online. Hopefully they got the blood clot stuff worked out and, and so we're gonna.

To those rural locations that don't require the deep freeze. So we'll see what happens there. I I, the reason I asked you about how you experienced healthcare is because I, I'm, I'm exploring this concept of if our habits have changed and have they changed enough or are we just gonna snap back to where we were?

And so there was a couple of interesting stories this week. One was hospital at home.

And, you know, we, we, we see 'em all over the place. There's, there's a new consortium that includes Ascension and Intermountain Mayo is, is making noise all over the place on hospital at home. The consortium is, is really lobbying for better policies and reimbursement for care at home. And remote patient monitoring and those kinds of things.

And then I also, uh, covered a story on today in health it around retail clinics. And it, it appears that retail clinics are also seeing a surge in, in, in growth in really their emphasis in the delivery of care. And I'm wondering, you know, we stopped going to the hospital. First of all, we were told to. And you know, if we had only done that for two months, I think things would've snapped back.

But we, we really have, have started to adopt new ways of receiving care, new ways of interacting. We've gotten used to some of these digital tools. We start to recognize when, hey, you know what, it feels like it's okay for me to just talk to a doctor via Zoom. I don't need to. You know, to go sit in the waiting room to wait to see somebody because it's, it's a lot more convenient.

Uh, you know, as we look at those things. Do you think the care venues are, do you think the habits have changed enough that we're gonna see a, a shift in a change in how care is delivered post covid? You know, I, and I think it's a topic we don't talk about too often because it seems to . I'm not sure if it's embarrassing or, you know, we, at the outset of this, there's a lot of warnings about mental health, but you know, we're underestimating the, uh, mental health issue that's gonna come out, uh, of this and I.

I will tell you, you know, my family, I know some colleagues, friends and family who, who had never thought about seeing or talking to somebody what was on their mind, what was bugging them, and have leveraged some of these, uh, telehealth services, telemental Health Services. Finally just talked with somebody.

You know, some folks have a problem getting actually the physical interaction of talking about mental health problems or what's on your mind. I think telehealth actually brings down some of those barriers where it might be easier to speak to somebody about your problems or what's on your mind over a video rather than going there.

It's, it's a lot of human effort and mind to get up there, get in your car, sit down and talk with somebody, especially about things like that. So. I, I, you know, that's what I've been keeping an eye on. You know, I, I have no problem saying I've used it for that purpose. It's been really helpful. And I, I see that as the, the big wave.

I mean, telehealth with a primary care physician, Hey, I've got a rash. Those type of things, that's not gonna go away. But I really think there's something to be done on the, on the mental, uh, side. Well, I think that's part of what.

The type of care that you're asking for with the type of delivery, right? So you get get on the phone with somebody within that seven twenty four sixty minutes or 60 seconds, you get on the phone with somebody and say, Hey, I've got this problem. And they say, great, you, we, we'll hook you up with a telehealth consult.

Or you know what? You need to get to an emergency room or.

The, the care with the most, with the, with the most efficient model for receiving that care. You know, clearly the, you know, the big winner is all of us, but the big winner, uh, of really moving forward is, is behavioral health and mental health via telehealth. I mean, this has been eye-opening in terms of the, the challenge plus it exacerbated the.

Isolation. Yeah. Isolation is one of those things that just drives people to have those, you know, those, those thoughts which can be debil debilitating at times. And we, we really need to interact with each other and, and so this, the, the use of telehealth in that space was a natural fit, and that will be one of the things we all talk about coming out of.

We, we, we saw that, I don't like the word sometimes, but it, it, I think it's a good explan. It, it democratized behavioral health. I mean, now it's avail available to everybody. I just, I'm, I'm excited about it. Uh, I'm excited about it. 'cause again, so many people have wanted to go speak with somebody or had something on their mind or something they wanted to fix.

And it's amazing that technology could finally address something like that. I want to talk to you about work from home. I, there was a, an article in the Wall Street Journal I covered on today in health it, but I'm gonna talk to you about this, this image that David Chow shared in social media this morning.

And it's from a study that Microsoft did on people working remotely, and it, it really gave them two options, thriving and surviving. During the, during the pandemic in your work from home environment, and they broke it down by business leaders, married, working mom, gen Z, frontline workers, new employees, and single.

All right, so we'll play a little game here, thriving and surviving. If you are a business leader, how, what percentage do you think are thriving in this, this new remote work environment? It depends, right? I think as engineering coders, I wouldn't say they're thriving. Uh, we've all sort of adjusted to figuring out how to, it's in such a collaborative process, especially developing software.

Being in the office, it's probably missed, but not 50 50 shot for me. Yeah. It's, it's 61% say they're thriving. Really? Yeah, it's, I'm a bit of an introvert, so I, I like that quiet time sometimes to get things done. Maybe it's the engineer in me, but I think that type of person or that type of job profile could thrive in this.

It's great. You know, sometimes I get two, three hours of work done. Go do something, take a hike, take a walk. And you don't get that at the office sometimes. Yeah, exactly. You just go from meeting to meeting. Um, yeah. We'll, we'll play a little. Price is right. This is a better way to do this. So married people who are married who are doing the remote work thing, greater or less than 40% are thriving.

I'd say less than it's actually, it's actually barely greater. It's 46% say they're thriving. But again, that's a 50 50 proposition there who are saying, look.

As a married person, uh, single, greater or less than 40% are thriving. You're trying to look, you're trying to look this up on the internet right now, right? No, no. I'm just grabbing some water. No, I, I'm not cheating like that. It's actually less so single. They're saying only 30% are thriving and 70% are struggling.

Interesting. And actually a lot of these, you know, working moms is roughly 50 50. Gen Z is 40% thriving, 60% struggling frontline workers, 40% thriving, 60% struggling new employees. Now, I, I, I will let you guess at this one, how many new employees you think are thriving in this new environment. So they started, let's just say they, they've been with the company less than a year.

What, what percentage do you think are thriving in this remote work environment? Oh, it, it must be near 5% because I, I know, I'm trying to what's the number? Uh, the number is 36%, but Really, yeah. That's, that's, that's a lot higher than I, I would think it would be. Yeah. You know what? We've brought on a lot of new employees and we're taking an effort to really reach out to them, virtually our arms around them, because.

Talk about a bad, a hard time to start a new job and not meet people and be isolated. It's, it's taking a lot of extra cycles from all of us to get those not folks up, only up to speed of make them feel part of the culture. But I think that's a, that's really high. Well, you guys are a tech company. You think you'll go back into the office when, when this is, uh, behind us?

Yeah. I think it'll be a hybrid, I think. And that's that article you guys talked about, you know. It's even similar to tech in the cloud. You know, I think everybody thought that is great. I can, I can move out of the Bay area. I can, you know, live in, in Kansas, but, you know, everything ends up being, you know, not so black and white.

It ends up being a hybrid. So we will see, we will definitely be a, a, a hybrid company going forward. It's open that the job pool up for us. I think that's an interesting side benefit of this is, you know, I have a, a friend who's gonna work out of Greece for, uh, a a month. Uh, so now we can pull people that were once just in the Bay Area, but we can pull people in from anywhere around the world.

So it will be hybrid and I think we're gonna actually gonna get a new diverse set of talent. Well, and the crazy thing is, you know, like where you live and whatnot, there's bidding wars going on in these remote. People moving outta New York City into, uh, you know, I've heard of people bidding up, you know,

it's my wife's a real estate agent and has never been busier and we've, we've always had a. The second place out in Colorado and we went out there to try to fix it up, and it's just, everybody's moving everywhere up into the mountains, so it's driven everything up quick. Crazy. Right now. Yeah. We have, we have friends who just moved to Montana.

I'm like, does Montana have the internet? I, I, I don't know. But, but it turns out that they do, and it's a, it's a good place to, to work from. Yeah. The, you know, so you go, you go to hybrid. Somebody's moved to Colorado during the pandemic. I mean, are, are we gonna say to them, Hey, look, your, your home office is New Jersey and you have to be in the office two days a week.

Again, I think it's all gonna depend on role if you're customer facing. And eventually we will be out there, uh, in front of our customers with our customers, again, partnered. It all depends on the role. I think the being a tech company and still global, I think one of the issues we're running into is. That, those silly time zones where, you know, I I is California the, the place now, it's a tough, it's a tough time zone to take care of AMEA and APJI, my, my boss is in India often.

And trying to find that time is tough. And now you take that, spread it across, you know, three geos, six different time zones. It's, it's, it's tough. Yeah. You know, I used to travel, like, I think the, the year I traveled the most was. And I used to be really good at timezone math. I found that that is one of the skills that I've lost with not traveling is timezone math.

I can't tell you the number of times I've said to people. Yeah, yeah. We'll meet at, you know, three o'clock central and I do the math in the opposite direction. It's, uh, yeah. And maybe we'll come up with, uh, universal time, right. Universal. Somebody will come up with a universal time or some algorithm to fix this or and we'll just call it this time.

And you know, obviously where, where the sun is and times, but you know, a lot of talk about this daylight savings work any longer. It's amazing. Back to the snow globe, you know, it's making us uh, rethink about things like that. Time zones, where do you work? It's, uh, it's fascinating. So what's, uh, what's next for VMware?

What are you guys, what are you guys focused in on and, and what are. You know what we, we, our healthcare journey started 2005 ish. When we were starting to work with the pharmaceuticals. We had this crazy idea of a hypervisor and. The pharmaceuticals issue was, you know, how, how do I move workloads into research environments and if I have to change the hardware out or software, you know, that could take months to recertify against the FDA.

And that's where we took this idea of a hypervisor and, and sped that up Now. You know, we were, then we moved over into the provider side and we said, you know, what are some of their issues they had been dealing with? And it was, boy, you know, we going on some rounds to see, and this was a long time ago, but yellow sticky pads with passwords on every nurse's station.

And we worked on some BDI solutions. That's where our always on point of care had had come by. You know, we've done, I, I'm proud of what we've done over the last 10 years that our high tech and EMRs running on, on VMware and I. We've been sort of, what's the word? H to some degree, we know that VMware think really helped us a long time ago with the server consolidation, but with work from home care at the edge, the cloud, you know, like I said before, everybody was running to the cloud as to do everything there, and it's going to be a native, it's going to be a hybrid experience, so.

What we're really focusing on is get that value proposition that the company was built on in terms of moving a workload from any server or letting it go to a, a desktop and VDI and we extend that into the cloud. And I'll let you run your VMware workload with our, um, relationships with Amazon, Google, and Microsoft to extend that VM to go out there.

But even taking it one step further is . Using the Kubernetes container as that, the, the new workload, uh, the container, so to speak. So this whole idea we have is, you know, we need to help simplify healthcare. It, there's a lot of simplification to be done. There's too much complexity. We can bring automation to it.

Second side would be, is modernize. There's a lot of. Technical debt out there, both from a hardware application perspective, so working on helping companies modernize both healthcare IT as well as ISVs application providers. I think that's gonna open the world up to this innovation I keep on using the snow globe analogy.

It's if we can simplify things and get more smart people focused, uh, not on looking at that red button of something going wrong and making sure you hit every Tuesday and getting to work on innovative products, uh, and projects. Uh, that's what we're looking to, and I'll leave you with this. It's, uh, this working from home care at the Edge Care in homes.

We have a lot of work to do as an industry to secure those devices. It's, it's the wild West out there. During Covid, we sees devices just ended up everywhere. And now as we sort of try to rationalize that and we don't want to take those back, right? We, we here at the edge is great. Now we need to figure out how to lock them down and make sure that person, that tele radiologist, that caregiver, that patient, has a great experience.

'cause if they don't, you know, they're gonna be coming back into the hospital. That's something, you know, we, we don't wanna lose those, uh, gains we made through telehealth. Yeah. And that, you know, one of the biggest challenges in the security front has always been the, the biomed devices. And now we're talking about these, you know, hospital at home.

We're talking about these. Devices going into the home that, uh, really raised the level of acuity that we can do out of the home. But, and, you know, we did some interesting things to secure them in the, in, in the hospital setting, but I'm not sure those same methods work once we moved them to these remote locations.

And, you know, there's, there's a lot of, it's, it's, you can tamper with those things and cause harm. You can tamper with those things. Collect data, data, and you can also use them as a gateway into other systems, which might have more valuable information depending on how the, the transport mechanisms are secured.

So I, that, that's one of the areas that I think there's a significant opportunity for someone who is going to secure all those devices in the home. It'll be, that'll be an interesting space. Keep an eye on. Yeah, there's, uh, I, I will a shout out to, uh, John Gomez and Cindo. I think that if you wanna know anything about securing, uh, devices, medical devices like that, John Gomez has been working on this forever.

He's, uh, so check out his web website. He's got some great blogs out there as well. But you, you're, you're, you're head, you're right. It's, it's different about having a PC in the user's home. We know how to take care of that, but we cannot let that . Managing and securing that medical device from any manufacturer got almost where it's coming from.

But think of patching, hacking a Windows desktop has become pretty routine. You really just can't do that with these, with these devices. It's gonna take a different type of thinking. Well, Frank, thanks again for, for all the referrals. Thanks for coming on the show. I appreciate it. I, you know, this great conversation and, uh, always, uh, appreciate your support of the show and, and all the things you've done to get us to this point.

Three and a half years, I can't believe it's been three and a half years. Crazy. Yeah, yeah. Well, we're, listen, we, we we're really, we really, you provide a great service to the community. Great service to my company. This is something I really championed when I was in the chime board to, uh, the CPAs event, trying to get the chime CIOs and foundation members to communicate better, learn from each other, and you've just, uh, certainly amplified that globally.

So we appreciate all you do for us. Appreciate it. What a great discussion. If you know of someone that might benefit from our channel, from these kinds of discussions, please forward them a note. Perhaps your team, your staff. I know if I were ACIO today, I would have every one of my team members listening to this show.

It's it's conference level value every week. They can subscribe on our website this week, health.com, or they can go wherever you listen to podcasts. Apple, Google. . Overcast, which is what I use, uh, Spotify, Stitcher, you name it. We're out there. They can find us. Go ahead, subscribe today. Send a note to someone and have them subscribe as well.

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