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May 6, 2024: Laura Oโ€™Toole, CEO at SureTest joins Bill for the news. She propounds on a myriad of subjects rooted deeply in our current tech-healthcare ecosystem. As they probe into the AI labyrinth, could they be overlooking the persisting inaccuracies? How is the role of AI shaping up in data governance amid the accelerated pace of technology? Is the regulatory burden in healthcare stifling innovation or serving as the checks and balances for it? As they ponder upon these, they also deliberate the contentious issue of the FTC-led ban on non-compete agreements in terms of the nuanced needs of the industry. The discussion further meanders into acknowledging the vision and strategies that health institutions have opted for. Does infusing AI in healthcare truly hold the potential to revolutionize the industry, or are they standing on the brink of another technology bubble?

Key Points:

  • EHRs and EPIC versus Cerner
  • The FTC Vote
  • Non-Compete Agreements
  • Effect of AI Integration

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

Today on Newsday.

With anything, I think there's balance in this. You need people to have the ability to work where they want to work. But I think that health systems should also have the ability to protect their interests. โ€ŠMy name is Bill Russell. I'm a former CIO for a 16 hospital system and creator of This Week Health. where we are dedicated to transforming healthcare, one connection at a time. Newsday discusses the breaking news in healthcare with industry experts and ๐Ÿ“ we want to give a big thanks to our Newsday partners,

Clearsense, Sure Test, Tausight, Order, Healthlink Advisors, Cedars Sinai, Rackspace, Crowdstrike, and Fortified Health .

Now, let's jump right in. All right. All right. It's Newsday. And today we're joined by Laura O'Toole with Suretest laura, new background and everything. Welcome

thanks, great to see You

It's interesting because I was talking to somebody and if you look up in one of those things like Definitive or ZoomInfo, if you look up CEO of Suretest, My name actually shows up.


Yes. And I, said, why do you think that is? I said probably because they have algorithms that look at these shows and go through them and they hear CEO and then they hear my name and then they hear your name and we're both listed by the way. So we're co CEOs of SureTest, which is I don't know.

I'll take it. I'll take it all day long. I put you on my advisory board to give us good guidance for a reason.

Oh, absolutely. I'll take it. Yes, and it's, and I love working with you and the team. It's, fantastic. It just, it cracks me up that, people talk about AI and the accuracy of AI and those kinds of things.

At the end of the day, we still we are not we're, not there yet. We're not at a point where it can scrub that look at a couple more articles and say, Bill Russell is not the CEO, he's an advisor to Suretest it's just pretty interesting.

And it's amazing because you wonder why we're gonna need some strong data governance around ai, and I think the technology's moving way faster.

than the governance just in general.

Yeah. A lot of those conversations, but since I have you on the line, I try to pick out the stories that I think are really in your, in whoever the guests, the wheelhouse is. And I found this one to be interesting. U. S. healthcare is mind numbing burden.

This is the advocate CEO. So Eugene Woods, CEO of Advocate Health, highlighted the significant administrative burdens faced by American healthcare systems during a live interview with the Harvard Business Review. He criticized the overwhelming number of codes. and regulations that complicate patient care delivery and the reimbursement process, noting that physicians and health care providers are mired in bureaucracy that delays or denies necessary reimbursements.

Woods is collaborating with the AHA to simplify the healthcare system and draws on international examples like Spain to propose a shift towards enhanced primary care access and public health investment. And he advocates advocates for Doubling public health funding in the U. S. to realize substantial societal returns.

I, I held this story for you because, you guys live in that world of, trying to simplify that burden. I mean that and we hear this all the time and, a lot of times what it gets relayed as is the EHR is stifling healthcare. But is it really the EHR that's stifling healthcare, or is it all these regulations and burdens and requirements and you have to document this 10 times and all those things?

I'm curious what your thoughts are on this story.

Yeah I think it's, I think it's accurate. And I think our clients, I don't think it's the EHR specifically, I think it's all the mitigation of risk that you need to have in place and making sure that you're adequately testing your integration strategy and watching that patient go from the point of entry into the health system.

all the way out the back end to when you want to make sure you get their claim process. There's things that organizations just have to do to make sure that's a seamless event. It is a burden. It's a lot of work and there's a lot of hours being spent manually that don't have to necessarily.

Yeah, it's interesting.

I'm glad that Eugene Woods is getting out in front of this and talking about this. I think there is a a challenge that the, challenge being that we are, it feels like we're stuck. We're not making progress with regard to access, with regards to the complexity of healthcare. We're not making as much progress as, as we would like with regard to the costs clearly.

And I think it is going to take some new thinking about this, not just tweaking what we already have, but maybe some new thinking and new approaches to this in order to make progress in those areas.

And I think it's like anything take a Lean Sigma approach, you have to make sure that you're getting through that workflow in the most efficient way that you possibly can, and then where there's opportunity to automate certain things so that your folks can be working and operating at the top of their license level.

That's what I want for our clients is You know, more satisfied employees, more efficient work and the ability to really be about how do I work with my business to engage more patients and make sure that our patients have a seamless experience when they enter the health system.

Yeah. Let me ask you this.

Have you ever signed a non compete?

I have signed a non compete.

Yeah. Yeah, me too. The FTC has voted, by the way, unelected officials have voted to prohibit nearly all non compete agreements responding to 26,000 public comments and tales of workers hindered by these contracts. The ban will exempt only pre existing agreements with senior executives and aims to free roughly 30 million workers from such restrictions.

The change is expected to boost wages. by nearly 300 billion annually by enabling freer job transition. The U. S. Chamber of Commerce is expected to to challenge this ruling. And the other story, just to bring all these together, hospitals slam FTC's non compete ban. The Federal Trade Commission voted 3 2 to prohibit non compete agreements anticipating 194 billion in healthcare savings over 10 years despite the limitations and regulations.

Regulating non profit entity, many U. S. hospitals might still fall under this ruling. So they're saying, hey, this doesn't affect the non profit health systems, but it affects the for profit health systems. That's interesting. It will also affect the the vendors that are partnering that happen to be for profit.

And there's, they're looking at this saying, hey, look, this rule is just unfair. And it's, interesting to look at this. Rule, a world without, I understand a world without non competes. But doesn't the ruling have to be more nuanced than just all non competes are bad, they're all gone?

No I, agree.

And I think it's about disparity, like many things, unfortunately, in healthcare, right? So for some of our smaller or mid sized hospitals, or those that are scratched and clawing just to stay and keep their heads above water, I think it's going to pose a real problem for many of our health systems that are already struggling significantly.

to attract and keep talent.

It's interesting I have no problem with senior executives at HealthSystems signing non competes and even enforcing some non competes. Now, I don't think they should be endless. I think there's 12 months is really enough to say, look, they're not going to leave, take all the secrets and do whatever they're going to do.

Oh, they know they're going to be opening a new cancer center down the street and it's going to they're going after this physician group and they're doing these things. I don't want them to leave tomorrow and go Hey, we should shore up that physician group. We should do these things, whatever, and have that be part of their barting chip.

Like I was on the inside, I know information, therefore you should pay me. for the situation. So that's why those things exist in that world. It's like, how do I as, a leadership team, how do you invite people into the, to the inner workings of the thing without having some sort of protection that, and I guess the FTC would say then take care of your employees so that they don't leave.

It just seems too simplistic.

It is. I think it's, way oversimplified and I think it's going to make some people just go rogue or think that they can go rogue. And I don't think that's going to be, that's going to be good. I, would imagine there's going to be some other layer of even more enforced NDAs.

You'll see, you're going to see another legality come in to try to protect. The interest of these health systems if this goes.

I was shocked to read that there's hourly employees who have non compete agreements. Oh yeah. Look, that should, that absolutely should go away. That makes no sense to me whatsoever.

Look at gosh, even from an EPIC perspective. Think about that, Bill. If you're working on an engagement and you could be an hourly consultant, Working for, not a consultant, but an hourly employee working for that health system. You can't go leave and go work for another one. You're going to get you're going to get blacklisted.

Like with anything, I think there's balance in this. You need people to have the ability to work where they want to work. But I think that health systems should also have the ability to protect their interests. Particularly their investment arms and if you think about if you're working with a vendor, let's say you're working with a startup vendor, and you've invested heavily in this vendor to be a pilot client.

And with that came some restrictions on timing, and making sure that Client pilot gets to success before the company goes on to five others. And if the health system or the investment arm of the health system, which happens a lot, you know this, makes an investment. I agree there needs to be integrity around that and making sure that you as a vendor, meet, your obligations.

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โ€Šthis, will be interesting to see that there's so many people against this. I'm sure it'll, be challenged in the courts and we'll see where this goes. And the courts generally aren't real happy with five unelected officials making a ruling that has this kind of impact.

With that being said, that's what they're there for is to make these kinds of decisions. Again, I pulled a story because I know this is one of your clients. AtlantaCare's transformative six year plan includes a med school, AI, and high profile partnerships. I like this. I like, when we get a glimpse into the six year plans, and this is called AtlantaCare called it Vision 2030, aimed at transforming healthcare delivery and community well being in Atlantic City.

Multifaceted strategy includes the creation of medical school in partnership with Drexel, University College of Medicine integration of advanced technologies like AI through collaboration with Oracle Health. Significant physician expansions expected to generate thousands of jobs, extend regional life expectancy.

The plan also focuses on addressing community needs by reducing food insecurity and homelessness, alongside establishing high profile partnerships with Cleveland Clinic Cancer Institute and Global Neurosciences Institute for enhanced care delivery. Vision 2030 seeks to not only expand AtlantaCare's service offerings and market share, but also elevate Atlantic City as a leading destination for healthcare innovation and education.

Yeah I love these. I love when a team goes into a room, brings people together and, thinks about, okay, what could health look like in these communities? You had a chance to read this. What, are your thoughts?

Yeah, actually, I was invited to go to the event just because we've been a long time partner with AtlantaCare.

And I was disappointed that I couldn't go because I would have loved to have seen Michael Carlton the, fairly newly appointed in the last year or so president and CEO speak. Because I hear he's extraordinarily dynamic. And he's really taken the organization on a pretty cool trajectory.

And I don't know if you've ever spent any time in Atlantic City and, or that area in Southern New Jersey, but I think it's brilliant if they're going to really move upstream and have a big trajectory in healthcare that they do this. It's a really interesting place, Atlantic City. There is a lot of homelessness.

There's a lot of disparity amongst care. And of course, you're not far from Philadelphia. And they have to figure out a way to attract talent to them to be able to keep particularly physicians and really get them ingrained. So I think some of the partnerships that they've created is spot on in terms of really taking advantage of being a leader in the market.

So I was thrilled for them. I wish I could have seen the presentation, but I heard a lot of people that were there and Certainly read the article and and I'm, excited. And of course, they're going all in with Oracle, all in with Oracle. And they're in that market, they're now Oracle's premier client to really take them on the, clinical AI journey as well.

I'm sure they're going to be doing a lot of application rationalization because they're going to try to move as much as they can. To the Oracle platform. So it'll be an interesting next couple of many years and I'm excited for them. I think they've really pulled together a cool team.

They've got a great leadership group. And I think they have an opportunity to make a real difference for CARE in Southern New Jersey.

And I like that perspective. I like the perspective of addressing food insecurity, homelessness. I like partnerships. Cleveland Clinic Cancer Institute, Global Neuroscience Institute.

I like those things. Going all in with Cerner is interesting. A couple of things this week. Let's see. Cerner is going to move, I think, It says their headquarters to Nashville. I assume that's their healthcare headquarters, but it could be their entire headquarters. I don't, I'm not really sure. I

don't know.

I have a question out about that because the thought of them not being in Kansas City is like weird,

yeah. Yeah. And that actually is already From people I know in Kansas City, they're saying that exodus already has happened. Which is again it's a pretty impactful thing for Kansas City.

The other thing I saw a quote from, from Larry Ellison that he said he expects to overtake Epic in the EHR space. I saw that quote and I thought, if you're Spend that much money to buy Cerner. I hope that's what you're expecting. What's it going to take for that to happen? What would it take for Cerner to overtake Epic?

That's a and we'll close on this because this is just a thought experiment because there's no

oh man


mean, I think that they would have to get The how many millions of physicians that operate in this country to really change their rhetoric and say, this works, and this is the way I want to use technology to care for my patients.

And I think Epic has always led with physician and clinician engagement into their platform. And. You've heard the opposite. On the historical Cerner side. So I think that's what it's going to take. I think it's going to take the caregivers stepping up and saying this new platform and what Oracle has done is transformative and you better go take a look at it.

Yeah, that is, it has to be transformative. And I think there's a, evolution that technology goes through and it just becomes. smaller and smaller until it fades into the background and it's just part of your life and you don't even recognize it's there. If Cerner can get there faster in the healthcare space, in other words, have it, have the EHR disappear from our, are, the, clinician experience all together.

So they just walk into a room, they engage with the patient, the note is created, the, and they can interact with the note, however they want. It could show up on the TV in front of them and they could say, yep, approved or no, change this or change that. If they can get to that sort of, I don't know, Jetsons like kind of thing where the technology folds into the background and just serves, that's The clinicians, and the administration, and the patients.

Faster than Epic, then I think you could, you again, it's a thought experiment. But that's what it's going to take. It's going to take something that people go, Oh, man, Epic doesn't do that, and they're far away from doing that. But we need that today.

Yeah, no, I agree. And that's from everything I'm hearing, that's where they're trying to go.

Very Jetson we'll see.

Ah, Cerner, the Jetsons of the EHRs. Now, that marketing moniker is probably not going to stick. We'll see. I don't

think so.

Laura, always great to catch up with you. Thank you very much for spending the time with us today.

Thanks, Bill. Always great to see you. I look forward to seeing you in person soon.

โ€Š ๐Ÿ“ ๐Ÿ“ Thanks for listening to Newsday. There's a lot happening in our industry and while Newsday covers interesting stuff, another way to stay informed is by subscribing to our daily insights email, which delivers Expertly curated health IT news straight to your inbox. Sign up at thisweekealth. com slash news.

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Clearsense, Sure Test, Tausight, Order, Healthlink Advisors, Cedars Sinai, Rackspace, Crowdstrike, and Fortified Health

you can learn more about these great partners at thisweekealth. com slash partners. Thanks for listening. That's all for now


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