Today in health it 10 observations and emerging health. It trends. Part two. My name is bill Russell. I'm a former CIO for a 16 hospital system. And creator of this week health set of channels, dedicated to keeping health it staff current and engaged. We want to thank our show sponsors who are investing in developing the next generation of health leaders.

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All right, yesterday we went through this article from Becker's 10 observations and emerging health. It trends. This is from a bunch of CEOs that were interviewed by Laura Dierdre or were on panel discussions.

And she has 10 takeaways. And it just to remind you yesterday, healthcare dollars are precious and digital technology spending is heavily scrutinized. Many health systems are still in the process of finding the right mix of in-person and virtual care. Number three, almost all health systems are having trouble recruiting and retaining it.

Talent and especially cybersecurity talent. Number four patient experience has become a priority. If not the top priority of CIO and chief digital officers and number five, a big opportunity for disruptors, including Amazon Optum. Walmart and CVS could be Medicare advantage. Alright. So those were the top

Today, we're going to go through the bottom five, the next five, number six, it departments have to embrace a yes culture, the old culture of gatekeeping what's possible. And turning down requests is no longer acceptable in healthcare. Instead forward-thinking CEOs are changing expectations for team members to take a more open-minded approach and work with other departments to solve complex problems.

The cultural Might mean losing ITT members who aren't on board. But the organization is stronger for Alright, this, um, Gosh, this should have happened. A decade ago. And was happening a decade ago. Anyone who's saying this now, their culture is well behind. The, , the trend. , ID departments and it's not.

By the way saying a yes. Culture doesn't mean, you're saying yes to every project and every. , thing that's coming down the pike. That's not the role. It's not part of the leadership team. Part of the leadership team is understanding. , what is possible and what is not possible, what is prudent and what is not prudent?

With regard to the use of technology. , and so you gotta be careful when you say this embrace a yes. Culture. Because it doesn't mean that it just becomes a doormat and everything that comes down the pike should

But it does mean that there is more of a proclivity to saying. , how can we make this happen? If this is a priority for the health system, how can we make this happen? Even though this is very challenging and difficult, how can we make this happen? Um, my only concern with this statement is it represents old thinking to begin with and what you need to do. If you're willing to take on this new level of thinking.

Is essentially open the flood gates to the possibilities. It's brainstorming at a different level and saying, okay, we haven't been able to do this for 15 to 20 years. Are we open to doing something completely different? Something a little, you know, something looking What other industries have done in certain areas?

Or what you think the new entrance into the market are going to do. So, anyway, this is the first one of the statements that I'm like this one's, it feels a little old. And a little cliche for me. Um, but anyway, yes, we do need to have that culture. That culture should have been in place. Let's see we're in 2022. Should've been in place in 2013.

So nine years Health systems are transitioning to the cloud. Some with one big move, including EHR. While others are taking a more piecemeal approach. The cloud offers benefits for data management and storage, cybersecurity and more. But not all applications are able to transition, which can make the process challenging, especially for organizations with significant technical debt.

The ability of new applications and startups to operate. In the cloud and integrate with the major EHR is essential.

Okay, so you, there's a couple of challenges here. Can this one. That's what I'm struggling with too. Because when I came into healthcare in 2012, we were talking about the cloud and we migrated our health system to the cloud. You've heard me talk about this before. I don't say it to brag. I'm just saying in 2012, we should have been doing this for all of the same reasons, the security models, better, the storage models, better data management, the interoperability and integration.

It's a better architectural model. For where healthcare is going, but that was true back in 2012. And the reason we knew that was because it was true in every other industry in the year 2000 through 2005. Right. So it's not new. So we are 22 years behind other industries. With regard to our cloud adoption and what's slowing us down. Is this.

This, um, these legacy applications that are the tech debt that they talk about in this statement. So while the statement is true, we are transitioning to the cloud in 2022. And, , we are doing it in ways that we haven't done before the EHR is, are going up into the cloud. We've talked to several health systems.

That are moving their epic implementation up into the cloud. Meditech has done a phenomenal job of rewriting their code to actually function in the cloud. , with Meditech expanse. And I think it's one of the reasons why these systems are well ahead of where Cerner's at. And that shows up in the class rankings.

, because they are designed. And starting to be designed around modern architectures, but it's also. The thing that's holding us back as is the legacy applications we need to rethink. How we deliver these legacy applications. I remember one of the biggest arguments we had in 2013 and moving to the cloud was around.

, PAC systems and storage of images and the conversation was you could never do that. And the cloud and we did it in the cloud because it's just a math problem. It's just figuring out latency. And bandwidth and what you can actually put up there. And then, , again, thinking differently, stepping back and saying, well, how could we deliver this? And with the technologies that were there, we had a caching mechanism, so we could set up regional Cassius. We stored everything in the cloud.

And then we've set up regional catches it's based on appointments. And people who are coming in so we could download those things. , in a, in a scheduled batch format to those cashed. , servers, but still all of our stuff was stored centrally, which gave us. Huge advantages from a cybersecurity.

Interoperability standpoint. Now we did that with radiology. We did not do that with cardiology. , I did not win that battle. So, um, we had four. , cardiology system, at least for, we may have, may have had four to six different cardiology systems. Because again, you're, you're talking with, , the cardiologists and that was a significant moneymaker and it was a diff difficult political battle to win. Um, at another time, I'll tell you what we did and how we, , set that up for success in the future. But.

Again, very difficult set of conversations. Number eight CEOs and hospital boards. Understand the need for high quality cybersecurity now more than ever, and are willing to invest in two factor authentication, email protection, cyber security, liability insurance. And more to manage risk health systems, large and smaller. Also increasingly taking a hybrid approach to in-house and contracted cybersecurity expertise.

To quickly flex up personnel during an attack. For vendors, a great, under a greater understanding of healthcare is paramount. For CEO's when selecting partners. Just working in federal government security. Isn't enough. Um, Yeah, I think that when at face value that's, , that's true. I think ever since the script.

, script's breach. , you know, prior to that, to be honest with you, we were looking at smaller health systems and I still don't think we were getting the board attention, but after the script's breach and the amount of information that they shared within the industry, I think people. , recognize that this is a serious issue. And I think we will be talking about the, um, obviously the common spirit.

Issue, , for years to come, , I don't think we will have as much information because I don't think, , that they are going to be as forthcoming with information on what went wrong. I hope they are, and I hope they do share so that we can learn from Number nine natural language processing would make a big difference in clinical burnout, but is currently cost prohibitive for many hospitals.

When the technology becomes more mature and further integrated into existing technology platforms, hospital and health We'll jump at the chance to have NLP in exam and operating rooms. Um, I think whoever this is coming from needs to do a little research. On the systems and what's available and what's out there. We've done a couple shows on it.

And not only the nuanced stuff. And I understand when they're talking about the costs, they're talking about nuance for some of the smaller systems. So they're struggling financially. The nuance solution might be a little cost prohibitive at this point, but it is a very robust system. You can do an awful lot

, I think the other thing you are going to see is the advent of some NLP. , on top of some, , artificial intelligent solutions, such as, , what we're seeing with artist site. And other things that we've talked about on the show. So again, I think this is a little dated. I think the research needs to be done. I think if you are partnered with nuance, you can talk to them about, , different models and potentially, , get something that is, ,

You know, Costs advantageous for your system. And then finally, number 10. Artificial intelligence still hasn't arrived in healthcare and there is a debate. On whether it ever will in clinical care, AI is being used for automation and operational efficiencies on the business And in the digital front door with chatbots, but there's still a lot of potential for meaningful AI.

In clinical care, AI shows the biggest potential with medical imaging and diagnostics. That's true. The technology won't replace physicians, but physicians enabled by AI will replace physicians without We heard, , there are also huge opportunities for AI enabled robots to complete simple tasks, such as hospital deliveries, similar to how robots are used in hotels, warehouses, and more, um,

, Jay, generally agree with this statement. Again, I will say that, , you know, we we've talked to companies this Again, but around imaging, we talked to some companies around the imaging that was really interesting, especially a mammography imaging and whatnot. That was just much more effective with the.

, with AI and the physician, rather than just the physician And those studies have been done and have been proven. And so clearly in the imaging space, I will say the other thing is, again, I keep coming back to artists that I liked the company. I liked the direction. Um, I talk to health systems pretty often about

Because it is probably the most revolutionary thing I've seen in healthcare. It, since I've been in here for the last decade, And when I sat down and talked to the founder about what they're doing, how they thought through it, the technology they're using, the form of AI that they're using and how it's being developed and the platform thinking that went into it. And the fact that each hospital can develop a new set of, , solutions that then can go back into the system and be used at other health systems.

And it's, um, I, it is one of the slickest things I've. Seen in healthcare. In the last decade. So, and, , I've been keeping a close eye as you So those are the 10 things. , I was a little harsh on these it departments embraced the S culture. I think should have happened a decade ago, how systems are transitioning to the cloud again should have been happening a decade at code, but it is happening now. This is absolutely true for the reasons.

Um, that they mentioned, which are, you know, data management, storage, cybersecurity, and other things CEOs in hospitals, understand the need for high quality cybersecurity. Absolutely. Since scripts. And definitely now since the common spirit, , attack, I mean, there was no, I mean the third, the fourth largest health system.

Nobody is safe. , natural language processing. , would make a big difference in clinical burnout, but it's currently cost prohibited for many hospitals. , again, I think they should revisit that and constantly revisit that because it is such a powerful tool for clinician burnout that you have to figure out a way to do it and do it well. And AI still hasn't arrived in healthcare.

Um, I think is a little bit shortsighted and, , and I think that, , we are seeing it. Come in at probably at the pace it should. Right. We should do the same kind of rigor that we normally do with new things in the healthcare environment. Is it, , you know, is it viable? Is it providing outcomes?

, is it, , negatively impacting care in any way? Are there unintended consequences? We have to look at all those things. When we're talking about care. , on the flip , I do think, you know, some of the solutions around imaging are absolutely And I think the stuff that artists are doing is definitely worth looking

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