Today in health IT health system or health platform? Does it really matter? My name is Bill Russell. I'm a former CIO for a 16 hospital system and creator of this week Health. A set of channels dedicated to keeping health IT staff current and engaged. We wanna thank our show sponsors who are investing in developing the next generation of health leaders.

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This is an interesting article. I think it has implications in the, , data space for sure, and the experience space for sure as well. So I will go into that in the so what, but I wanna give you the article first. Health. Here's what comes next. Hospitals evolved into health systems over the last several years with multiple care sites and expanded focus on health and wellness.

Millions of dollars were spent in rebranding and strategy to become health systems. Now the term is becoming obsolete. Health systems are so much more than care providers with ancillary businesses such as retail, pharmacy, venture capital. Which I think is, , drying up. But regardless, venture capital investing, telehealth Hospital at home and more, the best new term to describe evolving health systems has hasn't been universally defined, but a few organizations have begun internally rebranding Stony Brook Medicine's Growth Strategy isn't focused on more inpatient services or even expanding its 240 community based physician clinics.

Instead, the organization is zeroing in. On at-Home Services, urgent and immediate care and triaging patients appropriately. Stony Brook also includes five growing life sciences schools. We stopped calling ourselves a health system and started calling ourselves a health platform because we've got to have partnerships to make this happen.

Said Liz Popwell, chief Strategy and Transformation Officer at Stony Brook Medicine during an April 3rd panel at Becker's 13th. Annual meaning, all right, so panel discussion, and Liz was up there and said, Hey, we're moving from. Health system to health platform. We know we're not experts in all spaces and we need to find the right experts to partner with.

She said patients were willing to travel for care before the pandemic, but now they're looking for more convenient access and extended telemedicine and remote patient monitoring options. I would argue. They wanted that before the pandemic, but regardless, , that is truth. That is truth. People do want convenience and they want, , care closer to them.

The focus on at-home care models means Sony Brook is growing around the fringes of the platform according to Ms. Papaw. The forward-looking strategy extends to the systems medical and life sciences schools, training future clinicians and scientists. Many graduates want to stay local. Ms. Popwell said, which is good news for the organization.

We're not thinking about what's the care model of today. She said, we're looking about what it's gonna be for. 10 years from now, , we're going to start to implement different curriculum items based on artificial intelligence, machine learning, you name it. We're thinking about what healthcare will look like down the road so we can prepare the workforce for the future.

John Chorus, president and CEO of Tampa General Hospital and Florida Health Science Center at the University of Southern Florida said he doesn't think about the organization as a health system either. We look at ourselves as a family of businesses. He said, we are more of a conglomerate in a good way.

It's a notion of having all sorts of joint ventures and wholly owned subsidiaries. And of course, our. But it's really a family of businesses to address the healthcare challenges. Tampa General and Florida Health Sciences is a collaboration with the University of Southern Florida. Its health services division.

The organization has a large academic medical center and more than 130 locations and deep relationships with a few great partners. All right, so that's the story. That's the evolution. Let's talk about it a little bit. I'm gonna break it down. I'm gonna criticize it a little bit. I'm gonna encourage it a little bit, and then I'm gonna say, tell what I think needs to.

So, , my criticism for this is essentially, , I, I already started with this. This is what patients have been asking for for a long time. We've just now started listening to our patients because we had 'em. Right. All healthcare was local. They had nowhere else to go. They had to go to us. Well, now Optum's made inroads as CVS has made inroads and others have made inroads.

, not to mention the unnamed partners who have set up surgery centers and imaging centers and all that other stuff. We have to be more, , cognizant of what the patient's looking for. So important transition, necessary transition, but a transition that could have happened a decade. Right, if we were really listening to the patient.

All right, so we move beyond that and say, , are there any other problems with this model? And when we talk about a, a conglomerate of sorts, , of bringing businesses together, the other problem with that is you lose the value of vertical integration. And because you lose the, the, the value of, , vertical integration, , there's, there's cost problems, right?

When you start layering on different businesses over and over again, they each have to have a, an economic model. They each have to have a profit motive at a profit margin that has to come from somewhere. It's either gonna come from the payer. It's gonna, , come outta the provider's profit, or it's gonna, it's going increase the cost of care.

So I'm not sure this model right now as it sits, it's gonna be maybe more convenient and better access for patients, but it may not be a better model from an economic standpoint for the patients, , and the entire system. It could continue to drive the cost of care up, , within healthcare. So that's my concern.

Let's talk about, and by the way, I don't disagree with the direction. I think directionally this is what is happening. , the, the idea of partnering to get closer to the home and get into new services and provide different services is a, , almost a defensive strategy. It's not that. Obviously home-based care and AI driven care isn't the future.

It absolutely is. , and I'm not sure it's 10 years, I think it's two years. So if you're planning a a 10 year model, the 10 year model's gonna look really, really different. , when we think about the advancement that we've seen in the internet of things, inter internet of medical things, The connectivity in the home, if we're talking about 5G today, , and maybe six, , 10 years, six G and speeds that we can't even fathom at this point, because that's the speed at which the, you know, the network starts to improve and those medical devices get smaller, faster, , collect more information and deliver that information at the edge.

Now we're talking about, okay, what does, what does healthcare look like in 10? And when we're talking about this kind of model, there's two things I think about. One is, is data, right? You can have a conglomerate, you can have a whole bunch of businesses working together, but they have to have a phenomenal data fabric, a phenomenal, , exchange of data, a exchange of insights.

, and that only happens with an intentionally built data fabric that lies underneath the entire thing. And by the way, it's not the, eh, It's just not unless the EHR significantly evolves. And the problem with the EHR significantly evolves is we've already sewn the seeds for it, not evolving. It's, it's, we've, we've coalesced around one or two or three large EHRs.

And what happens when you get the market that small is the, the innovation slows. Believe it or not, it does slow down. They cannot keep up. And then the other thing is, if you have that many disparate systems, if you make changes too fast, you break too many things, you add costs to those existing players as they have to continually upgrade.

Now, hopefully we end up in more cloud-based, , , models. Where we can do micro updates across the board instead of these massive, every three months or six month, , release cycles that we have to take. Release cycles is an old model. It is a a wildly old model, and it doesn't take advantage of internet architecture, which is what the EHR needs to be built on in order to be a platform for this.

All right, so that being said, you need this data fabric that goes across the whole thing. The other thing that breaks. When you move from one business to another, to another, to another is the experience, right? So you have to start essentially architecting experiences that go across multiple entities.

Anyone who's done this before will tell you this is extremely hard. We are not that good at it. We within the health system, we need to be better at it within the health system. In fact, if you haven't started, I would take each one of your, your main areas, take labor and delivery, and map the experience from end to.

And then, and then knit that together into a really good experience. And once you have that experience, then go to orthopedics, then go to oncology, then go to the next, the next, the next, and build those out. Because you know what? That's a skill. That's a muscle you're gonna need to develop in order to go to the next one, which is doing that across multiple, , We had to do this for the bundled payments, , for knees and hips, and we had to do this all the way through the, , skilled nursing and the post-acute care services, which a lot of those we didn't have.

I'm just telling you the, the quality level as a health system, trying to maintain the quality level of those entities and then. , really the higher order things, just the quality level was not up to our par as a health system. So we had to work with them to bring that up to par. And then obviously the technology stack and being able to integrate that technology stack, which also was not up to par across that, is extremely difficult.

So when I think of this idea of health system to health platform, first of all, from a branding standpoint, it's gonna mean nothing to the consumer. They're not gonna go, oh, it's a platform. I get it. It's not a system anymore, it's a platform. They're not gonna get it. It might be good for internal. To explain what's going on.

Hey, we're gonna, we're gonna knit together a lot of different systems and get people thinking in the right vein, in, in the right direction. You know, how do we knit together multiple entities? And if that is the future, then , that's great. From a strategy standpoint, the strategists know to integrate all these things.

Are we educating them on what that means from a technology standpoint? So, , there's a lot to talk about with this one. This is, this is not a small. And I believe again, , I believe it's the right direction. I believe it's already happening. And so acknowledging that it's happening, getting ready for it to happen, and putting the right pieces in place in order to have the right experience and the right, , , quality, the right, , I don't know, insights and data that are driving it, and then the right cost.

Knowing that it's by, by its definition, if you don't do it right, it's gonna drive up the cost of care. You should enter it from an architect standpoint of saying, how do we make sure that this conglomerate model, this partnership model, doesn't drive up the cost of care? All right, those are my thoughts.

That's all for today. If you know if some of that might benefit from our channel, please forward them a note. In fact, if you have questions about what. Rattled off there. Feel free to, to shoot me a note. , forward them a note. Shoot me a note bill at this week, health.com. All right. Hey, if you have people who wanna listen to the show, they can subscribe on our website this week, health.com or wherever you listen to podcasts.

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