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February 22, 2021: Vaccinate. Vaccinate. Vaccinate. Sue Schade from StarBridge Advisors joins Bill to discuss the news. Sue has been monitoring vaccine distribution and sharing it with the community through her blog. UC Health released a must-read COVID-19 mass drive-thru vaccination playbook. Health officials are struggling to gather critical data including race, ethnicity and occupation of individuals who receive the COVID-19 vaccine. How can we make this easier for those on the front lines to capture? Can we do audits to see where our system has gaps? Some state systems are buckling under the pressure. What is a CIO to do in this case? And what’s going on in Texas? Will their vaccine reporting issues cost them less doses from the federal government? Epic’s platform now has 100 mass vaccination sites using it but remember it’s not a CRM. Is this a square peg in a round hole type situation? 

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Transcript

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 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 a channel dedicated to keeping health IT staff current and engaged. I ran into someone and they were asking me about my show. They are a new masters in Health Administration student, and we started having a conversation and I said, you know, we've recorded about 350 of these shows, and he was shocked.

He asked me who I'd spoken with and I said, oh, you know, just CEOs of Providence and of Jefferson Health and CIOs from Cedar-Sinai Mayo. Clinic, Cleveland Clinic, and just all these phenomenal organizations, all this phenomenal content. And he was just dumbfounded. He is like, I don't know how I'm gonna find time to listen to all these, all these episodes.

I, I have so much to learn. And that was such an exciting, uh, moment for me to have that conversation with somebody to realize we have built up such a great amount of content that you can learn from and your team can learn from. And we did the Covid series. We did so many great things, talked to so many

The brilliant people who are actively working in healthcare, in health, IT addressing the biggest challenges that we have to face. We have all of those out on our website, obviously, and we've, we put a search in there. Makes it very easy to find things. All the stuff is curated really well. You can go out onto YouTube as well.

You can actually pick out some episodes, share it with your team, have a conversation around those things. So we hope you'll take advantage of our website. Take advantage of our YouTube channel as well. Special thanks to Sirius Healthcare Health Lyrics and Worldwide Technology, who are our news day show sponsors for investing in our mission to develop the next generation of health IT leaders.

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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.

Alright, here we go. Today we have . It's a Newsday show and we have a, a, a, a guest host. I used to call you guest, but you're actually a host, a co-host of the show, and, uh, you haven't disappointed today. S Shade is back in s Shade Red, which I really appreciate. welcome, welcome back, Sue. Good to see you, bill.

Thanks. Wow. We're, we're gonna talk about a lot of stuff. I, I went to Disney World for over the weekend, so we'll talk about that a little bit. I think that's interesting. Plus I. Every now then I post something on LinkedIn and it gets a lot of traction. That's gotten 5,000 views in like 36 hours, so. I don't know if it's the Disney mystique or whatever, or people just wanna know what does it look like in Disney World right now?

And it, it could be a little both that, so, we'll, we'll talk a little bit about that and I, I'll, I'll tell you how I felt there and you could tell me how you, you know, feel about what they're doing with Advent Health and, and how they're sort of approaching it. I thought there was some really well thought out and interesting things they did and I think it.

It could be a precursor to what we see society sort of as we step back, right? As we step back, as we step into normalcy. Again, what it might look like and how we could sort of ease into it. You've done a great amount of work on the, on the vaccine distribution. Gosh, I, two, two stories now. Or three? Three articles You've written?

Three. I don't wanna say I've done work on it and I am not on the front lines in any way, but I have been reading a lot and tracking and yeah, I've written three blog posts now about what I call 'em vaccine rollout. It takes a village, part 1, 2, 3. So I've covered a lot of stuff. Yeah. I'll tell you what, we could, we could start on, 'cause I, I cheated.

You sent me one of these stories ahead of time and it was the covid playbook that, that the University of Colorado Health System put together. Did you get a chance to go through that? That is really amazing stuff. It's awesome and I want it shared widely. Obviously they're making it available and sharing it.

It's a, it's a covid 19. Mass vaccination, mass vaccination, drive-through Site Playbook. It's a comprehensive 59 page document. I skimmed through it Bill just to see like what all's there. It's from uc Health, university of Colorado Health in Denver. And they have done at their, whatever their stadium's called there, you might know Coors.

Yeah, Coors. Of course. So they've done several drive-through weekend events now, and you know, tens of thousands of people are being vaccinated, so it's great. Richard Zane is their Chief Innovation Officer and he is also their department chair for Ed, and I worked with him when I was at Brigham. He was at Brigham.

During much of the time that I was there as CIO, and I think he's been behind making this happen, and they said they would share their playbook, and I've, I've put it out there because I think I. Organizations that A, either are gonna do that or are doing something similar, can still learn from it. And you know, in healthcare we're all about best practices and sharing a absolutely.

In fact, I've gotten some calls from people saying, Hey, do you know of anybody who's done this work? And then this showed up and now I'm just. Everybody who called me, I'm just sending this to 'em and saying, Hey, here. It, I mean, it has, yeah. You know, it, it, it, they, they, I mean, I'm sure you could add to it if you really tried, but they have the organization structure, how it started, pre-event planning.

Uh, they have, they have it all the way down to the signs. They have a page where they said, Hey, here's the signs that we used across, and it's, it's in, uh, English and Spanish across the board. They talk about getting the vaccine there. How you store it on site, they, there's it components of it as well.

There's, there's, uh, standing up a network. Now we've gotten pretty good at this with the, with the testing sites, right? For the most part in terms of getting networks out there. But, but they go through it step by step. Okay. Are you gonna have access to the, the course field network, network and, and are.

They've provided and I just, the detail of it is phenomenal. They actually have the, the diagrams of how you bring cars in, how you flow them through, how you have them wait, there's a 15 minute, uh, wait period after you get the vaccine and then how you move them out and they share some of the stats. I don't have the stats.

Well, here are the stats. Lemme lemme pull it up real quick. The stats were really impressive if, if people are considering this, so they did this. Two six hour days. Okay. I'm sure there's probably more planning than the actual days. Right? That's usually how these things go. 10,000 vaccines were administered, 834 cars per hour, 22.4 minutes per car, including the 15 minute observation period.

That's impressive. I mean, I mean, they are, they're moving people through zero unused dose doses, and that's a huge stat. 'cause obviously when you, you take that out, sometimes there's unused doses that aren't refrigerated anymore and you have issues. 0.9% patient, no-show rate. Again, that's exceptional. I mean, a, a 1% patient no-show rate is, is exceptional.

And then all appointments filled within 72 hours clear. It's clearly demand for this. And, uh, does this, is this the kind of thing you only do in a major metro, or do you think you think we'll see this in some of the, some of the more regional or smaller locations? You know, that is a great question. And, and again, I think they have phenomenal results.

The metrics that you just shared, show that. And between you and me, let's get that playbook out there on social media for everybody to take advantage of. You know, other places that I've, I've heard are doing it are. I think somewhere in Washington state and Oregon, um, apparently Memorial Hermann in Houston.

So that's a huge metro area. They said they had, uh, best practice. They were getting calls. Atrium has done this in a, in a partnership with a number of organizations. I. All drive-through. So, you know, I think large metro areas and maybe, you know, some smaller, um, metro areas as well. The thing, you know, that's a drive-through one, but I would think that much of what they've got there is applicable to mass vaccination sites that aren't drive-through.

Right. Yeah. So here in New England at Gillette Stadium where the Patriots play, mass General Brigham has. Partnered with the state and an organization called, oh my gosh, I think it's CIC Health and I can't tell you what it stands for to do a mass vaccination site, but it's not a drive-through. Yeah. They are using an in a huge indoor facility associated with Gillette Stadium and here in, you know, I think in Worcester, Massachusetts, they're using a convention center here in Providence, Rhode Island.

They're using convention center, so maybe in the colder temperatures. They're not relying on the drive through, but park and go into some mass site. But I'm sure that 50%, if not more of what's in that handbook or playbook could be applied, don't you think? Yeah. That's. That's absolutely the case. Oh, by the way, thank you for sending Tom Brady down here.

I now live in Florida and we really appreciate the, the Super Bowl championship. That was, that was very kind of you guys, and I just, I just lost all my New England listeners, but it is, uh, he, he is a champion. He wins. It's crazy. Yeah. Yeah. I'm not even gonna comment on it. . We'll, congratulations.

Can we pivot to another story that I had linked to in one of my blog posts, please? Because I think it, it, it, it ties to what we're talking about with the mass vaccination and the , and that was a story when I first saw it on Rachel, made on M-S-N-B-C. And then I followed the trail and found the story in the Los Angeles Times.

So it's a community center, I think it's Kedron, K-E-D-R-E-N, in South Los Angeles, which is largely a, a black. Town area of South Los Angeles, I don't know the geography that well. And the physician lead there recognized the problem of, uh, disparities in terms of the vaccine distribution and they created a walk-in clinic.

So if you don't have a car to go to, what we've been talking about, you don't have internet access to get online and try to schedule and you don't have email, what are you gonna do? I just thought that that article was a great example of community-based efforts to address disparities and get vaccines into communities where it is harder to get to them.

Unfortunately, I have not seen a lot of other examples of that around the country, but I think it's a, it's a emphasis more and more to address those underserved areas. Yeah. There's, there's a, there's a couple things about that. One is. I, part of it is just the availability of the vaccine and so the health systems and whatnot that have it are have limited supply and they're trying to, trying to figure out scheduling and all that other stuff.

And so it's one of those that if, if you're not making a conscious effort, and they should be, but if they're not making a conscious effort to say, Hey, what about the people who don't have cars? What about the people who don't have computers? What about the people? In our community that are homebound and those kind of things.

If you're not bringing that to front and center, that has to be a concerted effort. That's one thing I would say. The second is, and, and, and that would, with the Sisters of St. Joseph, I was at St. Joe's in Southern California. They would always, every meeting we'd say, Hey, here's how the business is doing.

They're, they were like, thank you very much. Let's talk about the community and what we're doing. So I'm sure there are health systems out there that are doing this. That's, that it has to be a conscious, somebody has to be bringing it forward. The second thing is, and I'll give the, the administration, this administration, kudos on this.

I've been, I've been talking to a source, I'm not gonna reveal my source, but I've been talking to a source who is, uh, pretty closely linked to, to the, some of the activities that are going on within the government. And this is what they're using FEMA for. They are, they're starting to look at, okay. Where can we put these, these pop-up sites, I guess, to administer the vaccine?

At first, I was a little critical of this. I'm like, look, just, just get the vaccine out to CVS, Walmart, Walgreens, and it'll be out there. But they are specifically targeting some areas where you have these underserved communities, and that is gonna be the, and, and that's a, a great, great way to deploy those resources.

Get me in line as soon as you can. Get me in line. Get me in line. Yeah, I heard you, I heard that on your, yeah, so 20, 20% are still wait and see. Let's make sure that nothing adverse happens. But then there's this 30% and I, I've been focused on this 30% for a while yet. 'cause if, if we can't figure this 30% out, but that's what doing fe.

Subsection of the people that are in that 30%, and we're gonna go out them, we're be right around the corner, we're out the homeless. We're these people and those kind of things. You know, s the administration for, for doing that. It's, I don't think it's widespread. I think there's only four states that they're looking at right now.

I think it's, uh, Jersey, New York, Texas, and California. But I'm sure that'll expand. Yeah. Well, and some states are . I think some states started with that focus. You know, West Virginia was for a while, the state that had the, I never know how to describe this, but it's doses in arms as a percentage of doses distributed.

Right, right. And they were way up in the high eighties, 80%. My state is in the sixties, West Virginia. You know, I've heard the governor on a couple, you know, quick news interviews and he talked about we had to go to the people and not the people come to us. So they figured out in rural West Virginia how to get it out.

I know that in Rhode Island, it, it, it, it's kind of a double-edged sword. the. The, to have a really intentional approach is to, and they seem to have sub stratified a lot of specific groups that, that should be getting it now along with 75 year olds and over. They haven't gone below 75. And it's possible that that really intentional approach has also caused them to not have as many doses administered out of what they've been distributed, but.

Let me just before we leave this point, the big picture and for everybody frustrated, when's my turn? I want it. They're not the vaccine hesitant, but I want it. When's my turn? How can I get it? The site's open. Refresh, refresh, refresh. To get an appointment, you have to take the big picture view and look at how many have been distributed so far.

Shots and arms, and the fact that the metrics. The key indicators of hospitalizations, new cases and deaths are going down dramatically, well, significantly from a very high peak. Right? Yeah. So it's a good news story on the trend. The numbers are still way too high, but the vaccines are having an impact.

Well, we, we got exactly what we expected, right? We, we had, we had Thanksgiving and Christmas. And so towards the end of January you had, you had peaking numbers, right? Because we, people are just tired of, you know, the process and they're like, no, I wanna see my family. What I, I get why they did it. But we also knew the risk and we, we saw the numbers go up pretty dramatically.

That gets me to another story you shared, which I. Relevant to health it and that's delays with Texas Coronavirus Vaccine reporting system may hinder allocation of doses. Sorry. So actually lemme read a little bit of this. So, despite being plagued by reporting issues, data collected in Texas immunization reporting system may soon become a central factor in determining how many Covid 19 vaccine doses the, the state gets from the federal government moving forward.

According to January 20th, Texas Tribune report and sometimes. They, they're trying to sell newspapers. They make this because I, I can't imagine that the federal government's gonna, Hey, Texas, your reporting numbers are down. We're West Virginia.

What they're saying. But, but what they're saying is essentially, look, the reporting we're getting back from the state of Texas through their antiquated system isn't really accounting for all the, uh, doses that have been distributed and, and shots put in arms. And because of that, the algorithm that's used at the federal level is, Hey, look, we're at this inventory.

So we're not gonna send you some stuff, which is understandable. That's how inventory systems work. And so, you know, so health systems, and by the way, th this is from the Texas Tribune, and this is a, a Texas story, but I, I've heard this from other states as well. The state systems are not as, what, what's the right word here, because I, I, antiquated is a word I used before and.

They're just not sophisticated. They're not, I, I don't, you know, we've spent billions, literally as, as health systems on our, on our operational systems in most of our hospitals across the country. We have not spent that at the state level for whatever reason. And so these systems are, they're, they're sort of buckling under, under this pressure.

So

I. When you talk about the state systems, you're talking about the public health infrastructure. Yeah. And we've not as a country or states invested in the public health infrastructure. And I think that also is gonna get more attention coming out of this pandemic, and I think that's part of the Biden Harris administration plan as well to put more attention there.

And probably part of the $1.9 trillion that's being asked for what are, what are CIOs to do about it. You know, you can't, you can't make changes of significance when you're in the middle of it, right. I think that, you know, CIOs working with their . Executive counterparts in their organizations need to make sure that whatever data reporting is as clean, accurate, and current as possible, going to the right sources that it's supposed to go to.

And, you know, probably in the, in the, in the grand scheme of things, you know, participate in some of the advocacy work to improve this in the long run. I don't know if chimes, you know, all over this in any way or not in terms of their advocacy work and interoperability, but. You know, they may well be, but you know, you work with what you got and you find ways to, um, affect change in the long run.

Yeah, it's, it's, it's interesting. This is just me being pragmatic here. So I sit back and I go, look, and you have another story in here. You sent over so many stories. This is phenomenal. You, you talked about Epic has now.

I, I saw a Cerner stat on that as well, and it's pretty high, but, but that's where I'm going. So Cerner, Meditech, epic, and let's say Athena, you take those script. If, if, if the federal government would say, look, and, and I talked to Dale Sanders about this early on in terms of the data. He's like, we're collecting irrelevant data.

So this was early on in our field report series, and he's saying, look, they're just, they're overburdening the health systems. Were collecting this irrelevant data. And so they went back and said, all right, this is all the data we need. This is another one of those cases where, look, there's, there's five major EHRs, which is gonna cover 85% of all health systems who are administering these, these vaccines at this point.

So why don't we just come up with the clear data set that says, Hey, here's what you're going to submit. Here's what you're gonna collect. Create those fields within those EHRs, and then have each of those, those ER providers generate a. I don't know, a a a, I mean, at a simple level of report, but at a, you know, a future level.

Just so a simple way to query that information. Mm-Hmm. to say, Hey, this health system has ha we would, we gave this health system this many doses and they've administered this many, and if they wanna go deeper into that data, they can. I, it, it seems to me like this is not rocket science. We just need, I don't know, coordination around it or, or effort around it.

I don't know, and maybe I'm being too, too harsh here. No, I don't think you're being too harsh and you know, I'm a pragmatist as well and you know, I probably believe more in, in big government than you do. But, you know, at the time of crisis, which this has been for the past year, right? What has been our national response?

What's the, what's the partnership between public, private government. Can some of the, you know, can some of the work now coming fu, future coming outta ONC with Mickey Pathy, who is like all over interoperability. That's his kind of frame of reference and experience. I mean, can there be some partnership mandates, whatever, with, you know, some of those big vendors as to here's what, here's what we need, here's how you have to adapt.

If you're collecting this much, you need to collect this much more. I don't know. I, I certainly don't wanna sit and be the Monday morning quarterback with all sorts of, you know, opinions and critiques on what's going on. But, you know, clearly there is so much room for improvement on all those levels. So, so you and I are really busy right now.

I'm gonna transition to the Disney story in a minute, but you and I are pretty busy right now with, with our, our roles in supporting CIOs, supporting health systems and those kind of things. Yeah. What, what, what are the kind of things you're hearing right now? What's, what's going on in the field? Ah, that's a great question.

I'm super busy this week with a particular client that's got a big go live April 1st, and we're doing a independent, what we call independent verification and validation review. So we're, I'm kind of heads down right now this week with that client as to where they are at in the bigger scheme of things.

For all the people that I'm talking to, I think that

CIOs. Starting to pivot to some of their back burner projects as they look at their 21 agenda. But I would say in the last two months, most people that I've talked to, it's vaccine, vaccine, vaccine and being flexible, change on a dime. We're gonna, you know, we're gonna stand up another mass site, we're gonna stand up another clinic.

We gotta get to our employees. You know, so pivoting back to the vaccine, and one of the things that they're dealing with is that variation on number of doses that are even available. So how do you know you have to be ready with everything to stand up a clinic on Monday if you haven't been confirmed that you've got the doses right?

Uh, so more and more CIOs are just talking about. The, the, the, the flexibility needed right now in their roles. Yeah. I, one of the things you, you said there, and you're talking about at Go Live, one of the things I'm hearing is in addition to just the words, in addition to, it's like, yes, we have to do all this covid stuff.

But we have to kick off all these back burner things that have been out there. And I'm like, all right, so what's come off your plate? It's like, no, nothing. Nothing. And, and what? Yeah. Whatcha hearing? Well, that's what I'm hearing. I mean, it's, it's in addition to, it's like, yes. We now all of a sudden have to be, become experts on, on getting the vaccine out to our entire community, which.

It's to the entire community. It's not just to your patients. So you can't rely just on your EHR database for outreach. You have to think, okay, well, we were talking about earlier, what about the people who aren't in your database, the people in your community who might go unreported or underreported? I know if I were still the CI at St.

Joe's, we had about 12% of our ER visits every, every year in Southern California had. Incorrect or no social security numbers, and you can read into that, whatever you wanna read into that. But essentially these are people who did not wanna be known in the system. So doing outreach to those people would require some very creative partnerships with whoever, with, with marketing for sure, but potentially with, with local, uh, community organizations and not to find these people and to make them aware of, of what's available to them.

But I am hearing in addition to, we have, we have new skills we need to learn and stand up, but it's, hey, we've gotta get back on, uh, foundation, back on our build back, on our update schedule. Oh, by the way, cybersecurity, it has not gone away. And in fact, it's quite the opposite. It's elevated in terms of it.

Visibility at the board level. I mean, so those are just some of the things I'm hearing. And uh, it kind of surprised me because I thought there would be one of the things that was great about, uh, the silver lining in Covid was focus, right? Yeah. There, there was a day that everybody came in and said, this is what's most important.

And it feels almost like we're snapping back and saying, Hey, everything's important again. I don't know if we're gonna be able to move at the pace we did last year, if we just throw everything back and say everything's, uh, a high priority item. Yeah. You know? Can we pivot to the, the, the story that I sent you about.

Where is it? It's the, it's the one about CEOs not getting distracted. . Right. Can we pivot to that? It, it seems appropriate. Sure. Yeah. Yeah. It's, yeah, I have it here. I, I print too much, so I've got some paper. I got some stuff, you know, pull up on my, so this, so this is a, a Becker's article. It's don't get Distracted on vaccine rollout.

Susan Casey, uh, who, who would you like to highlight here? Sure, sure. A couple people. So I think that Susan Casey, chief Quality Officer, physician, oh, I, interim Chief Quality Officer at University of Illinois hospitals and clinics in Chicago. She said the best advices don't get distracted, and this really does tie into what's going on for health systems right now.

And this is about, obviously the vaccine overall goal of our program has been to get vaccine out quickly and safely. There have been several points along the way where this, there is discussion and debate about priorities in order of offering. We found that if we focus on the broad categories outlined by CDCA, Chicago Department of Health, we can quickly offer vaccine to many people.

If we're not distracted by debate , we can focus on operations that allow us to move quickly through tiers and phases. Offer more vaccine. Every vaccine delivered has an opportunity to help us fight the pandemic. So that's focus. Get past the debate and discussion, right, and just get it done. Some of the other ones just talked about their cooperating principles in terms of the work they do every day.

Apply that to the vaccine. So you and I have both been in a, in a, in, in a number of organizations and health systems.

It leaders and their teams can have way too many priorities. Way too much discussion for way too long about getting something done. And you know, I've heard Covid speed in the last year. I hope that that continues. Covid speed, covid focus. Let's not get bogged down in some of the debates and, you know, focus on getting things done.

So. I don't know. I I may be rambling. . No, no, that's, but you know, I think that was the right pivot from what we were talking about in terms of everything they've got on their plate. And in addition to, it's kinda like back to core business on how, how to deliver, which health systems do they're, there are times a crisis.

They're there every day for people. Yep. I agree. Uh, you wanna hear about my trip to Disney World? Well, I listened to the, I listened to, oh, you To, well, hasn't listened to.

You know, I'll just give you some of the detail. We were actually a little nervous going up, and my wife and I talked about it, like, you know, if we saw certain things, we were like, all right, we're outta here now. Disney's a, a really well run organization. They're they, you know, even. Even we can argue, you know, is Florida doing the right thing or whatever.

But regardless, Disney as a microcosm within Florida, you would expect it to be top-notch. And, and they really didn't disappoint. I was, I was, uh, really surprised. I thought, you know, I, okay, I've been here many times. We went there on our honeymoon. That's one of the reasons we went back was. Anyway, it's her, her, her father died over the holidays and we decided, alright, we're gonna, we're gonna take a trip.

And actually we had planned this before because she was a caregiver and she was giving so, so much of her time. I'm like, you need a break. And so we, this is what we were gonna do. Mm-Hmm. . And, uh, so we talked about some of the things we said, you know, if, look, if they're not gonna be with people wearing masks and people are, will.

There's, there's a little too much risk there. We, we, we'll, we'll look at that and determine whether we feel comfortable there. There are a couple places in Florida that we have visited and have gone, you know what? I'm gonna wait until this pandemic's over before we go back to that place because that's, that's not safe and.

And I have my friends who are like, oh, you're overreacting. I'm like, nah, I'm not overreacting. I mean, I, I don't need to go to that store. I don't need to go to that restaurant. I, there are other restaurants that are acting appropriately, so I, I'm just gonna go there and I understand if you wanna do your, whatever your, your protest movement by shopping at that store where you don't have to wear your mask, then you know at it do what you do.

That's.

We were surprised. You know, they're, you're talking to little kids, you're talking three and four year olds that had their masks on. I thought, oh, clearly the kids are gonna be taking their masks on, and they weren't. And it's really, that was fascinating to me. The other thing is, as you would think, I mean the signs are clear when you're coming into the park, you get this stuff ahead of time.

You know you're gonna be wearing masks your whole time masks over your over a million times. When you're, you know, walking around, things will come up. I did think, the interesting thing to me was the, there were, they looked at some events and they said, you know what? We can't control the crowds. And you think about it, it's like, well, Disney always controls the crowds.

It's like, no, there's, there's events like the fireworks. And the fireworks was. I was disappointed not to have the fireworks. It's one of the, it's one of the things that makes Disney magical, right? You go, you stand in front of the castle, you see the fireworks over there and they've gotten so good at it over the years and, and they just said, look, if we do anything that causes people to just congregate, they're gonna congregate.

So they did away with that, they did away with parades, they did away with, uh, a lot of shows, freestanding shows. They just said, look, we we're, we're not gonna take that risk. So when my wife and I after the first day, we sort of looked at each other and said, no, I feel, I feel very safe here. They installed the, the plastic guards and those kind of things.

So you listened to the show, sort of describing some of the things. They, they took the, the monorail. The monorail to me also was very interesting because public transportation essentially within Disney World. When you get on, they've created compartments. And so, you know, there's a thing for two, a thing for four.

I don't know that you can do this in the New York City subway, but I can't imagine going on the New York City subway and feeling safe. Can you, I don't, I dunno how that, how that would, how that would function. So. You heard all these things. How does this sort of translate? Let's, let's fast forward and say we get to 50% of the population vaccinated about, you know, 20%, 20%, 10, uh, 10 to 20% have had the, have had the virus itself.

We, we get to these numbers where it's like, okay, we're bordering on, it's safe again, but we just, who has it? What is this gonna look like? How are we gonna step back into society? You know?

Fascinating conversation, and I did listen with great interest and I can see, I think before we started recording, did you say that five, it's had 5,000 downloads already? That that, yeah. 5,000 views. Yeah. Yeah. So is that, is that people who are like, oh my God, I wanna go on vacation. That's what it's gonna be like.

I was thinking of Disney, I've heard Disney is safe or what, but. I think, I think we're all starting to think about after my husband and I over dinner last night, talked about a vacation that we had to cancel and now we've bumped out and we talked about what that might look like, how safe, and you know, January 22 and what we might need to be concerned about it.

It's gonna be different. Your description of Disney was different. I love the fireworks as well. The parades. The parades are great. The characters, you didn't mention that, but you talked about how the characters were not, where people, kids could run to and congregate and take pictures, but they were on a balcony or they were over here and you could see 'em, but not that con congregating.

So there was a part of me that's like, okay, good. They did a good job. And also sad. It's like, okay, that's a different experience now. And what, what will things be like in the future? But we're all adjusting to the new, and I think, I mean, you did a great job describing that and, and posing some of that, you know, the two points you made at the end.

'cause you're, do you, you do the so what Yeah, the health. Is it, what's the health system that is connected to them? Uh, advent Health, advent Health, that, you know, here's another revenue source for health systems as they look at how do they work with . Organizations in their community. And I think your other, so what was around digital, digital health and the digital experience and how good Disney is at that and how we need to be good at that within healthcare.

So, and those are my takeaways as I listened to it. Yeah. There was no, um, and, and I, and let me tell you this, the first, the first vacation that we canceled in 2020. Was to Disney. We were supposed to go to Disney at the end of April with my daughter, son-in-Law and two of the four grandchildren that have never been to Disney.

So when you describe the experience, it's like, okay, that'll be the experience when we do get to go, I guess . Yeah, I the, so two things on that. One is we drove, I haven't been on a plane since. February of last year. Yeah, me neither. And I'm not my, now my, my daughter has, she went back to school on a plane and my wife has been on a plane and they describe it and it was different.

So my daughter was on a plane back when their seats in the middle were empty. When my, by the time my wife went on a plane, she said the plane was packed from beginning, from front to front to back. And I'm like, ah, I don't, I don't know how I feel about it. So we drove. So I felt relatively safe there. The, the other thing is, at, at one point my wife looked at me and said, do you think they'll ever bring the fireworks back and the parades back?

I'm like, yes, I do think they will bring them back. I think so. Yep. Yeah. And, and they, they're just looking for the appropriate time. They're appropriate. All, all those things. So, and the other question she asked me is, do you think we'll wear masks? I'm. I, I think we will see, you know, you saw this in Asia, right?

Right. If you went over to Asia, if you went to Japan, you went to, you would, you, you would see this. And somewhat in China, it's about the air quality because there's such a coal producing, uh, kind of place. But in Japan it's, it's relatively, you know, it's, it's relatively common to see people with masks on as well.

And Mm-Hmm. , I think we'll see more people who just as a course, daily course will wear masks. Even if you fast forward two. Everyone's vaccinated. Maybe we're beyond this. We'll see that I, I and I, I understand the argument. I mean, we've had no flu season to speak of . Yeah. Would, would, wouldn't that be interesting to, to really take a huge dent out of the flu se season every year?

But I, I'll be honest with you, I'm, I'm not willing to give up, and this sounds kind of harsh, but I'm not willing to give up Disney fireworks and parades two years from now. You know, for a 2% chance that I'm gonna get the flu or a 5% chance. And we, we could argue with that. And I, I think, to be honest with you, we need to have this discussion, not today.

Yeah. Everyone should be wearing their mask today. I, I get that. Yeah, absolutely. Yeah. But, but at some point there's, there's gonna be this ar there's gonna be this conversation of, okay, everyone sort of gets to make a decision. I, if that's.

Ostracizing the other side for, you know, whatever. Yeah. It's, you know, mass became politicized. Covid was downplayed, and here we are, and now we're trying to get through it. What life looks like when we are through this, we're not sure, but it will be different and many of those things will come back. Many of those things will come back, you know, slightly changed.

So, so, so let's talk about trying be optimistic. Let, let's, let's close this out on a an it note and that is, uh, the digital experience at Disney was, was exceptional. So again, one, one of the things I said is hardly any contact transactions happen, even the front desk. I checked in to our hotel before we arrived, and so when I arrived they essentially had stuff.

But it was like, I checked in, they handed me things, I went to my, to my room. They gave you the option of somebody coming in and cleaning your room every day or not, which they usually do. But this was the more pronounced in terms of, you know, do you want this or not? We, in-room dining was interesting. The, the restaurant was at, at half capacity because it was indoor, only indoor dining.

So they, they cut down the capacity pretty significantly. So it was about half. Then what they opened up was indoor dining, where you would call. Now when they came up for indoor dining, you didn't get plates and silverware and all that stuff. They brought it to you in a, it was like a Uber Eats kind of thing.

So here's your, here's your food. But the reason I I bring this up is I, I spent a lot of time on my phone while I was down there, and every transaction I can think of was on the phone communicating, ordering food. You know, I, I think we've gotten used to that in our home world, that we, you know, we order Uber, we order food and that kind of stuff, but we sort of step back into some of these things when we go into healthcare.

Here's your clipboard, and you're like, you know, really the clipboard be gone thing has to be, uh, almost like the facts, you know? It's like, let's, let's get, let's get, let's get that. If you see a clipboard somewhere. If you see a patient with a clipboard somewhere within your health system, that is an opportunity for digital and needs to be addressed.

And I'm sure there's a handful of others that I'm not even thinking about at this point. Yeah, y you know, I think the, the, the point on that is Disney was already very much there, right? In terms of their digital and their, their consumer experience, their customer experience, so. They probably didn't have to take it up that many notches for what you're describing, right?

So the healthcare systems that have been ahead of the game in terms of digital and are there are in a position to take it up those few notches pretty quickly. The ones that haven't been thinking about this yet and are not there, have a long way to go and. I think we're, it's, it's a focus that we're gonna see.

You asked about, you know, what am I hearing, I'm hearing from a lot of people, they're trying to figure out their digital health strategy, their digital front door and, and beyond. So it is, it is a, it is a definite focus that has been a. Probably gotten more executive level attention too. Great. In the past year terms of the, the need and the importance.

Well Sue, every six weeks you and I are gonna get together on this show. We're gonna talk about things. So, and it feels like excellent. It still feels like six weeks, might as well be six months. It feels like so much happens between each time we get together. Yes. So who know, know we'll talking about the next time.

All right, well, thank you. All right. That's all for this week. If you know of someone that might benefit from our channel, please forward them a note. They can subscribe on our website this week, Healthcom, or wherever you listen to podcasts. Apple, Google Overcast, Spotify, Stitcher, probably some other places that I'm not even familiar with.

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