This Week Health

2021 Predictions Revisited: It’s time to face the music. Maybe a little early tor review the predictions but I had to go through them for some prep I was doing for a show so I thought I would share them and let you give me a grade.

I’ll make the 2022 predictions in January sometime. Hope you enjoy.

Transcript
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Today in health, it, we are going to revisit my

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predictions from earlier in the year, actually from early February.

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We had three shows, which we did predictions on.

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I'm going to try to condense that down into two shows and

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we're going to see how do I do.

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Did I get anywhere close.

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My name is bill Russell.

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I'm a former CIO for a 16 hospital system and creator of this week and

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health it a channel dedicated to keeping health it staff current and engaged.

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All right.

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Let's just jump in.

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Here's what I'm going to do.

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I'm just going to play these episodes in their entirety, cutting down some of the

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parts, just so you can get the gist of it.

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And so that we could fit it into two days and just let you decide,

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how did I do, let me know how I did bill it this week and health it.com.

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Here we go.

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Let's just get right to them.

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My first one is.

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It's really around cloud and cloud adoption.

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So, uh, Microsoft is winning the move to the cloud and healthcare.

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There's no doubt about that.

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This was one of my predictions from last year, COVID threw a serious

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wrench into all predictions, but this one held up in spades.

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In fact, COVID help Microsoft.

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, the reason people go to Microsoft is because it's the incumbent and they make

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it easy with their renewal agreement to just check a box and get more software.

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You know, in, in, in a crisis, Ms.

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Teams became the go-to platform for remote work and collaboration for

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just about every health care system.

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I'm on, I'm on a lot of team teams meetings these days.

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Uh, this isn't the only reason they are winning.

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Uh, they also have a, a tool set that, that doesn't require any change to the

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existing staff skills when you move to the cloud or, or at least not much of

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a change, let's just say it that way.

Bill Russell:w, data moved to the cloud in:Bill Russell:t is really my prediction for:Bill Russell:

There w there will be the start of a serious move to the cloud for

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healthcare, uh, and, and specifically healthcare data, uh, Mayo and

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Ascension have tapped into Google.

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Cerner's tapped into AWS.

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Providence has a massive agreement with Microsoft, uh, and health catalyst, uh,

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is built on Microsoft for that matter.

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Uh, 20, 21.

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We'll see health systems go beyond extending into the cloud for data

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platforms, and there will be full on use of the cloud for data tools and cloud

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data platforms will be used extensively for non transactional data requirements.

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with a transactional systems really starting to follow.

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Irish was designed for the cloud.

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Uh, but I think you're going to see the, uh, performance enhancements

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and other things that come along with the new architecture is

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going to allow epic to fully.

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Work in the cloud.

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So that's a 20, 21 prediction.

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I think we're going to see more cloud data, uh, movement from healthcare.

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We're going to see a data platform start to emerge.

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We're going to see cross data platforms and, uh, interesting agreements

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start to form between health systems.

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To share their data for the, uh, for the good of all.

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Uh, let's look at, uh, prediction, number two, the federal health emergencies going

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to continue through the end of this year.

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Right.

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And why is that important?

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And while it's important, because tele-health funding is attached to it.

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Right.

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So we were all worried during the election, you know, is Trump going to

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continue the federal health emergency?

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And back then I said, this is the silliest conversation going.

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This is at least going to continue through the end of the year.

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Okay.

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So we got through the end of the year, we're looking at this and we're saying,

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where are we at with regard to number of people who have had COVID number of

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number of people who have been vaccinated.

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And, uh, and then you can just look at it and say, let's make the

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prediction of how long the federal health emergency is going to go.

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Essentially saying we've got another 11 months of the federal health emergency.

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I don't think there's any rush to pull this thing off.

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I think we're going to get stagnated some somewhere around July timeframe,

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where we have plenty of vaccine, but not enough people lined up and we're

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going to sort of stutter through that.

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Uh, we're going to be stuck at a, uh, I dunno, let's just.

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Uh, 60% rate, which by the way, w will be fantastic, uh, compared to where we

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are, we were at, uh, in December and where we're at today, um, the, uh, the

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virus will slow down significantly, but with that being said, the

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federal health emergency is going to continue through the end of the year.

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So the biggest thing that means for health, it is that, uh, you

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know, tele-health funding, uh, or telehealth will remain funded

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And this is a chance for every house with some to really build out their

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capability with a viable funding stream.

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So if I told you, look, we're going to fund tele-health for the next 11 months.

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So, you know, continue to build out that you have a revenue stream for

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streams is going to come from.

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Uh, that to me would be a huge opportunity.

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You're you're essentially you're backstopping my, my,

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all my telehealth efforts.

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And.

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You know, so obviously people are going to ask you too, how

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Uh, you know, it's, it's really the age old, you know, there will be, uh,

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there will be lines where CMS comes in and funds they're going to fund,

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um, uh, behavioral health is going to be funded at almost full parody.

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Uh, states are going to try to jump in.

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They just don't have enough money to fund it.

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Um, but you know, the question is where CMS going to fund

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it, they're going to fund it.

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They're there.

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They're going to have a trove of information, and they're going to

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look at where it has been effective and they're going to fund it.

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They're I think they're going to fund it around a remote health, into

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a rural and underserved communities I think will remain funded.

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So there's going to be a, a, an actual funding source, but you can also.

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Look at lowering your costs, improving efficiency and outcomes.

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And, uh, there's also that, that aspect of, uh, the patient experience

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and improving the patient experience because we've done that we can

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actually draw more people into our health system in the long run.

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So that's a, a, that's a significant move.

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The last prediction is for today is returned to bundles and bundled payments.

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And I talk about this on today's news stations.

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The, uh, you know, bundled payments was really something we saw during the Obama

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administration and essentially took things like knees and hip replacements

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and said, look, we're going to look at all of the organizations that deliver.

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These kinds of services across a significant geography.

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And we're going to see what the cost variation is to deliver the same service.

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And so they looked at, let's just say, knee replacement, they've looked at knee

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replacements across this large swath.

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And they said, oh my gosh, look, I mean, the disparity is huge.

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Here's what we're going to do at CMS.

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We're going to say.

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A bundle for knee replacement starts at diagnosis and ends at when you're

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actually walking without a Walker or a cane or that kind of stuff.

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So it ends up full recovery and we're going to assign a certain amount to that.

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And it's going to be based on, I don't know the mean or the average for a

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certain geography for delivering that.

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And that was, that was the norm during the bide, during the Obama administration.

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And therefore it's not hard to extrapolate.

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That will probably be the norm, uh, coming into the Biden administration.

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We're going to see a return to bundle payments.

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Uh, so, you know, what does that mean for health?

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It, well, bundled payments are hard and they're hard for a couple of reasons.

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One is, you know, you might be one of the people that's above that mean, or

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that average, in which case you're gonna have to look at driving your costs down.

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Uh, the second is you have to, you have to orchestrate the care.

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And a lot of times that care starts before your health system gets involved and it

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ends after your health systems involved.

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So it stretches your capabilities.

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It stretches your digital capabilities to stretch stretches

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your health systems capabilities.

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You have to figure out a way to deliver a good, I mean, it's

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really not at the diagnosis stage.

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That's actually the easy part.

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The hard part is, is really after.

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It's the rehab.

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It's the, it's the rehab facilities.

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And, uh, where in a lot of cases, we're not owned by the, by the health system.

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In which case you had to manage quality, you had to pass data

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along to those facilities and you had to manage the delivery.

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Uh, so that you didn't have any complications or those kinds of things.

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Cause quite frankly, your payment is fixed.

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You're not going to get any more than that payment.

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Therefore you had to make sure that you were within or below that payment.

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And so technologies play a huge role.

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They play a huge role in a couple of ways.

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We talked about data and.

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Transporting the data across the entire continuum, that's obvious, but

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the next one is, is really the, uh, the, the whole recovery mechanism.

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I think you're going to see a lot of different tools driving care

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out of the home and how are we going to be able to, uh, manage and

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orchestrate the entire experience?

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So that has multiple touch points with technology to determine

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pain, to determine, um, you know, complications, uh, to have people

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come back at the right time.

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So you'll have, uh, the types of digital tools where you're checking

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in with a patient on almost a daily basis, if not every other day.

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Uh, digitally so that you can track that patient from beginning to

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end to ensure that you are going to get the outcome that you need.

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to the two bundled payments.

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I don't know what they're going to bundle next.

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That would be a good prediction.

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I should, I should probably think about that.

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Talk to some people, figure out what they're going to bundle

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next, but, uh, um, you're going to see follow through on that.

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And that is where we're going to go.

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So that's the first wave of predictions.

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You have a move to the cloud specifically with data platforms and lo and behold,

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this year we had true Veta and we had, uh, some other solutions that came

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to the market, which were significant for the good of mankind, kind of big

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data data platforms, but that's not all we, we saw a lot of stuff happened

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with individual health systems making moves to the cloud, uh, with regard

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to their data platforms as well.

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a lot of transactional systems.

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Moved to the cloud as well, such as EHR platforms, which will be

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interesting to watch at least.

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We will see that start to happen.

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At a, data backup and recovery kind of solution.

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, the second prediction was federal health emergency.

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We'll go through the end of the year.

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, because we will get stuck at somewhere around 60% vaccination rate.

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It turns out my state is currently at 60% vaccination rate state of California.

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62%.

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Vaccination rate.

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And so we still have the federal health emergency in place, which

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means the tele-health funding.

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Is still pretty much intact for health systems.

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And the returned to bundle payments.

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Uh, it remains to be seen whether we're going to see that really go.

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, anywhere, but, , I, I believe that we are going to see return to that.

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We're going to see that expand and continue to expand.

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going on and the transitions.

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That happened at the federal government level, but, uh, 20,

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22, I think we could see that one.

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Come back again.

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Uh, that's where I'm at today.

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I feel pretty good about those three predictions.

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There's about four or five more tuning tomorrow and you'll hear the rest.

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And then you can give me a grade.

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I'd love to hear it.

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That's all for today.

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