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

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

We had three shows, which we did predictions on.

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

we're going to see how do I do.

Did I get anywhere close.

My name is bill Russell.

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

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

All right.

Let's just jump in.

Here's what I'm going to do.

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

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

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

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

Here we go.

Let's just get right to them.

My first one is.

It's really around cloud and cloud adoption.

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

There's no doubt about that.

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

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

In fact, COVID help Microsoft.

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

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

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

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

just about every health care system.

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

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

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

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

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

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

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

Ascension have tapped into Google.

Cerner's tapped into AWS.

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

is built on Microsoft for that matter.

Uh, 20, 21.

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

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

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

with a transactional systems really starting to follow.

Irish was designed for the cloud.

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

and other things that come along with the new architecture is

going to allow epic to fully.

Work in the cloud.

So that's a 20, 21 prediction.

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

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

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

start to form between health systems.

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

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

to continue through the end of this year.

Right.

And why is that important?

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

Right.

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

continue the federal health emergency?

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

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

Okay.

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

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

number of people who have been vaccinated.

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

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

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

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

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

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

going to sort of stutter through that.

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

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

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

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

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

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

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

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

capability with a viable funding stream.

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

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

streams is going to come from.

Uh, that to me would be a huge opportunity.

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

all my telehealth efforts.

And.

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

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

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

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

Uh, states are going to try to jump in.

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

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

it, they're going to fund it.

They're there.

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

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

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

a rural and underserved communities I think will remain funded.

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

Look at lowering your costs, improving efficiency and outcomes.

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

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

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

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

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

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

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

administration and essentially took things like knees and hip replacements

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

These kinds of services across a significant geography.

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

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

replacements across this large swath.

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

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

We're going to say.

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

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

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

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

certain geography for delivering that.

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

And therefore it's not hard to extrapolate.

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

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

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

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

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

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

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

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

ends after your health systems involved.

So it stretches your capabilities.

It stretches your digital capabilities to stretch stretches

your health systems capabilities.

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

really not at the diagnosis stage.

That's actually the easy part.

The hard part is, is really after.

It's the rehab.

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

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

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

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

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

Cause quite frankly, your payment is fixed.

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

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

And so technologies play a huge role.

They play a huge role in a couple of ways.

We talked about data and.

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

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

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

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

orchestrate the entire experience?

So that has multiple touch points with technology to determine

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

come back at the right time.

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

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

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

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

to the two bundled payments.

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

That would be a good prediction.

I should, I should probably think about that.

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

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

And that is where we're going to go.

So that's the first wave of predictions.

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

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

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

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

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

to their data platforms as well.

a lot of transactional systems.

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

interesting to watch at least.

We will see that start to happen.

At a, data backup and recovery kind of solution.

, the second prediction was federal health emergency.

We'll go through the end of the year.

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

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

62%.

Vaccination rate.

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

means the tele-health funding.

Is still pretty much intact for health systems.

And the returned to bundle payments.

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

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

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

going on and the transitions.

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

22, I think we could see that one.

Come back again.

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

I feel pretty good about those three predictions.

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

And then you can give me a grade.

I'd love to hear it.

That's all for today.

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