Episode 472: Transcript - December 17, 2021

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

Bill Russell: [00:00:00] Today on This Week in Health IT.

Chris Logan: This is the elephant in the room. So if you go back to think about where we were 20 years ago with technology, it was different. So healthcare has gone through this mass explosion about how do we adopt these technology or these new innovations to provide better patient outcomes. It was not uncommon to have 2000 applications in your health system. How many did you have in your health systems?

Bill Russell: Welcome to This Week in Health [00:00:30] IT. This is one of our end of the year episodes. I hope you enjoy. My name is Bill Russell. I'm a former CIO for a 16 hospital system and creator of This Week in Health IT, a channel dedicated to keeping health IT staff` current and engaged.

I want to thank you again. In December we do a bunch of end of the year episodes. I think you're going to enjoy them. We do two with our advisors. I did one just me talking through chronologically the news of the year, and then we're going to do two, one where my staff selects the best news day episodes from the [00:01:00] year.

The second is you're going to get to meet the team and they're going to come on and talk about things. So this is one of those episodes. Before we get there though I want to remind you that for next year, we have some changes to This Week in Health IT. We're gonna have four channels. Four distinct channels on iTunes next year. We're going to have this week health academy, this week health community, this week health conference and this week health news. So, if you are already subscribed to the Today show that will [00:01:30] become the this week health news show, and you're gonna have the today show and the newsday show in there.

If you're subscribed to This Week in Health IT that will become this week health conference. And that's where we're going to have keynote. And we're going to have solution showcases and some other campaigns around specific topics. This week health academy is new. It's really around education.

We're gonna have a show called insights in there where we take the highlights from the last four years and we break them down into 10 minute episodes. They're going to air three times a week. I would use this show to mentor [00:02:00] people, to talk about what the various leaders in the industry have said over the last four years and how it relates to what you're doing at your health system. I'd also use it to bring people up to speed. If you hire somebody new into healthcare this is a great channel for that. And in this week health community is the channel where we're going to have guest hosts who are going to tap into their network.

And we have CIOs. We have CMIOs. We have clinical informatics. We have data scientists who I've tapped on the shoulder and asked them if they would [00:02:30] essentially interview people within their networks about topics that are a little closer to what you're doing on a daily basis. And we're excited about airing those channels. Again four new channels.

If you're not subscribed to all four of them, you're going to be missing some content. We'd love for you to subscribe to all four. Go ahead and hit thisweekhealth.com/shows and there's information there on how to subscribe. You can also hit iTunes and search for this week health. Any one of those academy, conference, news or community.

And you can [00:03:00] subscribe that way. And we would love to have you be a part of the community again next year. Now onto our show.

All right. Here's what we're going to do today. I love doing these clip shows at the end of the year. Normally what I do is I go through for the last three years, I've gone through a bunch of the shows, pulled out my favorite clips and done these end of the year shows. This year, I'm tapping into my team.

I now have three people that watch every show that we do. They either have to edit them, produce them, or they have to promote them on [00:03:30] social media. And so they watch every show that we do. And I asked them to pick the clips. So I didn't pick any clips this year. This is them. Their perspective. And they've listened to every show we've produced this year, which is a couple hundred at least 200 Today shows, 250 today shows about another a hundred or so on the This Week in Health IT channel.

So they listened to them. Just to give you a little background. None of them are from healthcare. They have been in healthcare. I think Tess has been in healthcare [00:04:00] the longest. She had just started working with me probably a little over two years ago. And so that is her background outside of all of them being patients and having interacted with our health system in various ways.

Tracey is our producer and Tracey's actually from Australia. She lives in the states lives in New York city, but she comes from Australia and so she's coming into healthcare from another industry and she's watching the shows and coming up to speed as well. And then Holly is our social media, a person who builds awareness of our programs and [00:04:30] shares the content out there.

She's been in healthcare on and off for about two or three years. She helped me early on in the show with some of the production and some of the work that was going. And then she went off and did something else with it and now it's come back to head up our social media. It really is going to be their perspective on what's important.

I love the clips that they selected. It's going to give me a good opportunity to give you a flavor of some of the things that we talked about in highlights some of the great content on the news day show. We start off with a clip [00:05:00] with Dr. Q. Dr. Quinones from worldwide technology and I were having a discussion on the different approach that big tech has coming after healthcare than say a traditional healthcare provider does. And with that introduction, here's our first clip.

Amazon, Apple and some of these other big tech players. They are consumer centric. I mean, Amazon is notoriously consumer centric. They know everything they do is around the consumer and how to make their lives better and how to make it [00:05:30] more efficient.

Health systems are provider centric and have been for decades. And I'm not the first to say this, obviously there's others. This is the famous quote from Geisinger's former CEO who's now acting role. Who said, the waiting room is indicative of everything we think about the patient, which is you will go into this queue and wait for us.

And when we're ready to see you we'll call you cause we are maximizing the time of the [00:06:00]provider. And so everything is about the provider. So that I think is the most stark contrast between big tech's approach. And they're always thinking, how can we make this better for the consumer and health systems approach, which is how do we make this better for the provider?

And I'm not against making it better for the provider. I'm just saying, is there a gap there that health systems have to close in order to not be evolved, I guess is what you're saying? I would say disrupted but evolved.

Eric Quinones, MD: Yeah, I [00:06:30] think there is a gap but I think they're becoming painfully aware that the gap exists. We as patients, we, I think of like, when I used to go to the doctor when I was a kid or when I would go with my grandparents, to the doctor, it was like, it was that old school relationship. Right. You just, like you said, you'd wait in the waiting room for 45 minutes past your appointment time, if not longer. The ED is worse by the way, as you know, so that's what we got used to, and I think what's happened, especially as [00:07:00] consumeristic demographics have changed.

That's not what consumers are used to anymore. Again they're seeing these experiences. They're having such as, you know, with retail applications that they're using that financial applications they're using, it's very seamless. You can walk near a Starbucks, you're not going to get a coffee, but you go walk near it.

And all of a sudden your phone shows you your favorite drink. And you're like, Oh, that's right. And maybe you do want a coffee. So it makes it, it's predicting what [00:07:30] you want right.

Bill Russell: Thank you for reminding me that I'm thirsty and I wanted one of your coffees.

Great conversation with Dr. Q. I really appreciate WWTs supported the show this year and lending their physicians to the show, to have these conversations on an ongoing basis. We're going to share another one with you here shortly. Anne Weiler is an advisor to this week in health. It. She's a former health tech startup founder who sold her company and continues to follow healthcare very [00:08:00]closely and work in the big tech world.

The context for this clip is we start talking about Microsoft Viva, the new product that was launched. And she started to share how different companies build empathy into their technology and why some work and some don't work so well. So, that's the setup. Here's the clip.

Anne Weiler: I did a talk at HIMSS one year on how to deliver empathy through technology. And I fully believe that it works, you know, that you can. And one of the examples I gave was when I [00:08:30] first got my first iPhone I was looking at it and it said you have a busy day tomorrow.

Your first meeting is at eight. And I was like yeah, I do. I do have a busy day. Thank you for noticing iPhone. And it felt, you know, like, okay, my phone is looking out for me. Let's compare this to something that Microsoft did which is, you know, Outlook gives you your productivity stats and they do it in arrears.

So they have been monitoring you. So in [00:09:00] January they sent me a thing that said, You have been working outside of business hours every day for the last month, except for two, one of those days was a Sunday and the other day was Christmas. Well I was selling my company. You don't think I know that I was working a lot!?

Bill Russell: Now you want to get in an argument with it and say do you not understand what I'm going through?

Anne Weiler: Those are some of the things that this brought to [00:09:30] mind and I thought about like the, rather than telling you what happened. Maybe come up with something that can help you. Like hey, I automatically put a block on your calendar because you've got these two meetings and you there's, you know, I know you're going to need a space between them to think because one of them's with your vice president.

It's a little bit squishy of thoughts but those are all the things that came up. And I was particularly like, do you want your portal every day to ask, like, are you happy today? Like, I [00:10:00] don't know.

Bill Russell: As you know, on This Week in Health IT we try to pull stories out and then have a discussion around them in this clip, Dr. Justin Collier with WWT, World Wide Technology we have a conversation around making the EHR work for the nurses. So here's the next clip.

The rest of our world, the rest of the technology that we're using is getting easier and easier. And so with every day that the EHR just feels a little clunkier, even if it was state-of-the-art the day it was installed. [00:10:30] It's maybe not keeping up to the, to the standardsof usability that's going on. So you sort of have that perception issue, but what are some mistakes, do you think that health systems make that, that lead to the nurses being frustrated with the EHR?

Dr. Justin Collier: I think the systems that do the best job. I'll frame it that way. So maybe best practices rather than pitfalls. Obviously the other side of the coin is not doing those things well. But I think the systems that do [00:11:00] best are the ones that have nurses on the informatics team. Nurses who have been at the bedside and understand the workflows personally. That makes a huge difference. And then the second step is engaging all of the stakeholders during the build process. So that they are part of that decision-making. Certainly that helps quite a bit in terms of adoption as well as potentially improving the usability. Third thing that really makes a difference too, is not stopping with installation or implementation or [00:11:30] the build. It's going back and doing continuous cycles of optimization. So continuing to improve that.

And then the fourth thing is not actually in the EHR at all. It's making sure that you have the right surrounding technologies that can improve the workflow overall for the nurse and doing as much as you can of that work to automate manual work, manual processes. Improve the overall workflow, leveraging all the best technologies you can. Hopefully that makes some [00:12:00] sense.

Bill Russell: Our next clip highlight Drex DeFord. Drex has been a phenomenal friend of the show. He's an advisor to the show. He's also been on probably more shows than anybody else. Since we started the podcast some four years ago. I love having conversations with Drex We have a very good chemistry and just sort of go back and forth. And we start talking about how you have conversations, how you prepare CISOs for conversations with the board. This was actually from an [00:12:30] article that was pulled out. It was the ExtraHop VP wrote an article on the things that a CISO needs to know before addressing the board. So Drex and I tackle this, this conversation. Hope you enjoy.

All right. So you're getting ready to go in and talk to your board. And you're a CISO. He says, number one, know your audience That's absolutely true. Not all boards are made the same. I know our board really only had one technology person per se on it. And that technology person was [00:13:00]incredibly savvy and was like the spokesperson for the entire board.

But it didn't mean that we didn't have to really be very clear and very basic about some of the things we were doing. We couldn't just speak to that one person on the board because our subcommittee of the board that handled security. We had to bring everyone along. We couldn't just speak to that one person.

And actually he was phenomenal cause he helped to bring the rest of the board along as well. So you'd have to know that audience. I assume most boards [00:13:30] today have somebody who understands cybersecurity?

Drex DeFord: I think so. If they don't have somebody on the board, they probably have somebody on one of the subcommittees of the board, like audit and compliance.

And so somewhere in there, there is an external resource that understands cyber security and you're right. I think cyber security for so many years led with fear, uncertainty and doubt. Scaring people into buying stuff for cybersecurity because, oh my gosh, what will [00:14:00] happen to us if we don't?

And I think the transition that has occurred, he talks about leading with resilience and managing fear is that yeah, of course, you're going to be afraid of what might happen. Nobody wants to be in the newspaper. Nobody wants to be the person with the microphone shoved in their face, but really the story has to be now I think and based on what he's saying, I think he thinks that we've created this situation in healthcare now where you can't provide modern healthcare without digital health. Without [00:14:30] the tools that we have EHR and DRPs and the thousand other applications that many of us run, which runs on, has to run on relatively modern networks and is connected to the internet because we're doing a bunch of this stuff, as we talked about earlier as a service.

And when you get all of that put together, you have to be really thoughtful about what happens if we go down? What happens if we go offline? And so you have to talk about it and think about it from the perspective of resilience. If we're [00:15:00] down for one day, what does it cost us? If we're down for 30 days what does it cost us?

And what are the things we can do to make sure that if something happens and we go offline, we can come back as quickly as possible to deliver great care to our patients and families, because that's what they're all about.

Bill Russell: There were a lot of articles this year about remote work And so a couple of these stories now we're going to cover. Remote work, its impact, and what's working, what's not working. In the first article. I'm talking with Sue Schade and we [00:15:30] take a look at a Wall Street Journal article, which talks about some of the changing habits and the changing perceptions of remote work. Here's a conversation with Sue Schade.

Let's hit this Wall Street Journal article. Wall Street Journal is "Remote work may now last for two years, worrying some bosses." Many employees develop new routines during the pandemic. Swapping commuting for exercise or blocking hours for uninterrupted work. These sound like good things. Even staffers who once [00:16:00] bristled at doing their job outside of an office have come to embrace the flexibility and productivity of at-home life over the past 18 months. Many say surveys have shown enthusiasm for remote work and has only increased as the pandemic has stretched on. And they talk about return dates being postponed by many companies. It seems like mostly they're talking large organizations here, but a lot of health systems would fall in that category.

And then the last two things I've highlighted in this article are perceptions of a remote work have [00:16:30] shifted as the pandemic has gone on. It seems to be a recurring theme in this. And what many have concluded over time is that there companies can operate largely effectively while remote executives and workers while remote. So they're saying, Hey, they can be effective operating remotely. Can healthcare operate well remotely is probably no cause there's a lot of physical touch points. Can health IT operate well remotely? What are your thoughts on that?

Sue Schade: [00:17:00] I don't know that my thoughts have changed significantly in the last few months. I continue to be concerned about IT direct support and engagement with our clinical users. The value of our folks who support those symptoms having close and in-person relationships, rounding, we were just talking about, I think is critical and that is very difficult in the remote world. And I think [00:17:30] that IT organizations need to find ways to accommodate that and structure it. And not assume that it can all be done remotely. That's the biggest, most targeted I know that for all the infrastructure work we're doing, we're making it happen.

If we've got to have people onsite and data centers or they can handle it remotely. We're just making that work fine. The other thing is the relationships overall and I connect with people that I've not worked with remotely [00:18:00] primarily over the last six months, it's like, I've told some of the leaders at the hospital on our Zoom calls. I just wish it were different. I wish that I could have been more in person and able to build those relationships that are so critical. You do what you can in this Zoom world.

Bill Russell: There's a handful of things I always say to people. One is you can't replace face to face. There's something about being able to read the person. Being able to sit across the table from them. Sitting in a restaurant.

I'm talking about these things like the good old days, but you know, sitting in a restaurant across from a [00:18:30] colleague, having a conversation, another colleague walking by and having a short conversation. There's, there's a lot of things that happen that are good in that, that I think we missed out on. I worry about the next generation.

I know this is effect. I I get emails every now and then on this, I know it's effective. I know you can be effective at home. I know that you can do your job at home. All those things are true. But I worry about the next generation missing out on the relational aspects of working with [00:19:00] colleagues. And I worry about them missing out on promotions that are going to go to people that have relationships.

Sue Schade: I think it's a valid concern. But if your whole team like take IT as primarily remote or some hybrid then everybody may be in the same boat, right.

But if we go from internal promotions to just the market overall and people moving around, there's a tremendous amount of people changing jobs. Leaving [00:19:30] where they are and taking other positions. And there's a huge increase in if it's virtual, I can work live and work anywhere You just kind of wonder how, I mean, I think this story is yet to be told. If you're changing jobs and you're virtual and you never meet your boss, you're never in-person, you never meet people you're going to work with two years from now. How does that play out? Where do you fit in that organization?

Bill Russell: This is going to remain an interesting [00:20:00] challenge and opportunity, right? So people really do like working at home. We're seeing the statistics and they continue to support the fact that people like the flexibility, the autonomy, maybe even the quiet space that a home offers.

But there are some downfalls and we covered that on several shows. And this one, we pulled information from a Microsoft survey. A work survey. Microsoft does some excellent work surveys. And they pull stats from their Office 365 platform. They do surveys to back that up. [00:20:30] And we gathered a bunch of really excellent statistics to talk about what's going on in this work from home world that we live in at this point.

And so this conversation is with Dr. Sanaz Cordes with World Wide Technology. And we are really exploring some of these statistics and what they mean for us as individuals from a mental health standpoint, from a work-life balance standpoint, if such a thing exists when your home office is right next to your living room.

And in [00:21:00] some cases I interviewed people this year where there, their kids were actually going to school right behind them. And we just kept that in the video because that is such a time capsule of the world we lived in in 2021. So here's the conversation with Dr. Sanaz Cordes.

Have you worked from home a fair amount of time?

Dr. Sanaz Cordes: Yes. I mean this last year and a half, every day.

Bill Russell: Prior to that.

Dr. Sanaz Cordes: I worked from home in the office and then on airplanes.

Bill Russell: It's interesting when I talk to people about this, when it first [00:21:30] started happening, I'm like, I don't think we know what we're getting ourselves into. I've worked from home probably 15 years out of my career so far. It's hard, it's challenging. Some of these stats sort of lend themselves to this. Self-assessed productivity has remained the same or higher for many employees in this past year, but at a human cost. Close to 20% say their employers don't care about their work-life balance. 54% feel overworked, 39% feel exhausted. And I [00:22:00] understand where that work comes from. Because when your home office is your office, it's you're sharing it with your home. And I know for me early on in my career, I couldn't shut it off. I can shut it off just fine now, but back in the day I remember when we first started getting these cell phones, I felt like I had to respond to every email that came through at whatever hour it came through and every text.

And I think [00:22:30] some people who are used to the office where they can compartmentalize it, I'm going to the office. Now I'm coming home from the office. They weren't used to that. And some of the things that took me 15 years to sort of develop . I think people are sort of getting buried under that weight of not being able to make that transition that quickly and that they are responding to emails.

They have some other stats here. Average meeting is 10 minutes longer. Time spent in Microsoft teams as a more than doubled globally. The average [00:23:00] Teams user is sending 45% more chats per week, 42% more chats per person after hours. Number of emails delivered to commercial and education customers when compared to the same month last year is up 40.6 billion emails.

Dr. Sanaz Cordes: I thought you were going to say 46%. I don't know where that billion ..

Bill Russell: 46 billion emails. There's been a 66% increase in the number of people working on documents and Office 365.[00:23:30] And so we're actually giving the company more hours. We're actually giving the company more of our, of our life.

And I think people are potentially resenting this. I think it's one of the findings from this survey. So as a manager, how would you approach that?

Dr. Sanaz Cordes: Yeah, no, I mean, I haven't always been a good manager. Like, like you, I was a workaholic and it was when I was working at home. It was roll out of bed, get on laptop, start pummeling people with emails and messages and, fall asleep [00:24:00] 13 hours later from exhaustion.

So I've learned just in the last year and a half watching what it's like for people who aren't used to that environment, how to adjust. And I think one really important thing, and my boss does this and this is and I was not good at this is to tell people I'm not going to respond to your emails after a certain hour.

I want you to have that time with your family and I'm not going to respond to teams. And he does that sometimes. And I think that's been really important, right? Like I think letting people [00:24:30] know it's okay not to send it to me because I'm not even going to be online, kind of gives them permission. Because I think it's just that fear of, if you haven't worked remotely, how do I show that I'm productive?

I need to be engaged and when it's 24/7, and like you said, in your house it's hard to kind of turn that off. So I think that's important. Setting the standard top down. Not going to answer, work-life balance is important. Take your weekend time. Words that we should have been saying all along, but really important now.

Bill Russell: So on Newsday we talked [00:25:00] about interoperability How could you not talk about interoperability It's such a big part of healthcare, and it's probably been a discussion topic for the last, I dunno, two decades and will continue to be with 21st Century Cures and other things that are going on. In this conversation, I get to sit down with Dr. Mark Weisman. One of my favorite people. He used to do the CMIO podcast. He became a CIO, became too busy. Couldn't do the CMIO podcast anymore and truth in advertising he would probably have to start doing this CIO podcast since he is no longer a CMIO. In this conversation. We talk [00:25:30] about what would Health interoperability look like in 2030 in a perfect world. And so I pose that question to Mark and here's his answer.

So health interoperability outcomes 2030. In a perfect world if interoperability worked the way it should work. Mark, what would it look like? what would it look like for a physician?

Mark Weisman: I would have a complete data set in my EHR that is accurate without duplicated data [00:26:00] that the patient has given consent for me to bring it all in together so I can get that view. I don't have to send off a release of information form to get it.

It's like real time. It's all there where I can get it into discrete data. Yeah. So I'm bringing in a note, but I want to be able to extract from that. Okay. Note the important parts so that I can fill in my health maintenance or my quality [00:26:30] metrics that need to be satisfied. Or if I want to trend the lab values that are being reported by a consultant, that's what it feels like.

It feels that's the easy button for healthcare. For me, that's what I want. I want the easy button of all the data right in front of me. Curated. And then I want to be able to ask my, EHR. Hey, I'm dealing with an abdominal problems today. Show me the relevant data, but EHR can't do that until we have a complete set.

Bill Russell: So at the end of this year, we finally got back together [00:27:00] and it was really refreshing. It was kind of fun to see everyone. And at the CHIME fall forum we set up a space right there by the registration booth And we invited CIO's to stop in and sit down with us to have a conversation And one of those people who stopped by with Dr Lee Milligan and I was talking to him about, he writes a lot. He writes articles. He writes stories about his time as a practicing ER doc. And he really weaves those things in, in a way and [00:27:30] includes some of those stories in his communication with his staff.

And he has a great way of building culture and really connecting his IT team to the mission of the organization. So I decided to pose that question to him, to capture it for all of you. So here's the discussion with Dr. Lee Milligan.

You're putting those stories out on LinkedIn. They're phenomenal. I've seen a lot of the feedback. It's great. But those letters, you have a way of capturing what's going on, connecting them to the mission in the, in those letters, which I think a lot of people are struggling with. [00:28:00] How do you keep them involved? And I mean, do you spend a lot of time on those or is that just so easy for you to just sit and write?

Lee Milligan: I try to find something that I feel strongly about. It makes it easier to flow when you feel strongly about it and then kind of focus on those things. But I also want to see through their lens, like, what are the analysts?

What are the network guys? What are the engineers? What are they thinking about right now? What's concerning them. And then try to start from that point and kind of work backwards on it. There's a couple other people out there, I think do a really good job of this. The CEO [00:28:30] of Korn Ferry, I think does an outstanding job of kind of connecting with, with his staff in kind of a similar fashion. And then I always try to bring in some story about my life to connect with my staff and

Drex DeFord: It is the connection to the mission and the connection to you. We hear this all the time. People don't leave jobs because of, I mean, any number of reasons they leave bad bosses. And when they have a connection with you and they have a connection with that mission, I mean, we have the greatest mission. That's our biggest advantage, right? We, we work in a [00:29:00] mission that everybody's a part of at some point.

Lee Milligan: One of the things we started doing within our our ICF division meeting every other month is we have our CMIO present some sort of clinical scenario where it played a key role in a clinical outcome.

So most recently it was a patient who came in with diabetic ketoacidosis. So it's a diabetic, they have super high blood sugars and then it gets super dehydrated. And it's really, it's a, it's a near death experience [00:29:30] with somebody who's experiencing that. And they had built out that, he had built out an amazing order set.

And the order set was so detailed and so specific. And so in line with best practice recommendations that frequently nowadays they turn these patients around so fast that when the hospitals comes down to admit the patient, they're asking, why am I admitted? And so the last time the CMI gave this example of this scenario, it was really all due to a great collaboration between the CMIO the clinical staff, and then the Epic, a set analyst who built this [00:30:00] whole thing out. So I think those kinds of things really connect us to why we're in business.

Bill Russell: We're going to close out with a story on cybersecurity, which I think makes sense. The primary story of 2021 has to be the pandemic. But the secondary story has to be cybersecurity. You had what went on at Scripps and as well as many other breaches but the Scripps one is you know, close to a 30 day outage of the EHR and some other primary systems. You had diversion going on, you had a hundred million dollars in lost revenue [00:30:30] as well, or financial impact to scripts that we reported on this show.

And we close out with a conversation with Chris Logan. Chris Logan is with Sensinet Used to be with VMware. Has been in healthcare for quite some time. And we just talk about the ever expanding attack vector that is healthcare applications.

The story is in Fierce Health which is one of my favorites to pick up stories. Let me give you an excerpt. Healthcare delivery organizations are under siege. As 67% have been victims of ransomware attacks. One third of [00:31:00] those said they experienced two or more, less than half the respondents completed a risk assessment of their third-party security vendor before contracting with them.

And more than a third said, the assessment conclusions were ignored. The report found. Gosh, I'm going to stop there for a second and say, does that surprise you? That so few are being assessed and the ones that are being assessed as being an org, it does surprise me by the way that the findings are being ignored.

Chris Logan: I think this is the [00:31:30] elephant in the room. Again, so if you go back to think about where we were 20 years ago with technology, it was different. So healthcare has gone through this mass explosion about how do we adopt these technology or these new innovations to provide better patient outcomes.

It was not uncommon to have 2000 applications in your health system. How many did you have in your health systems?

Bill Russell: 1600 applications. It was actually 900 distinct applications, but 1600 instances with potentially different access points, different [00:32:00] you name it.

Chris Logan: And so managing that portfolio, right. There's gaps. There is opportunity for improvement there. But what's most critically important here is availability. Right? So think about this for a second. When we were pen and paper for healthcare delivery, it was simple. You had somebody push the cart from medical records department. You got that full record. Maybe you could read it. Maybe you couldn't. Electronic medical records come to bear right now I can read the note. Is it the right note? There is a whole litany of conversation you can have there, but the availability of the system is [00:32:30] so damn critical now to ensure that patient's safety. At the end of the day, if I don't have that information how can I treat that patient? If I don't know what their background history is, right. If I don't know what their previous inter allergies are related to specific medicine. So availability attacks are nothing new. I mean, ransomware really is an availability attack. This has been taking place since way back. 2003, we went through this. It was not our medical systems. It wasn't on the EHR. It was [00:33:00] on all the administrative systems because it was really making the endpoint unavailable. Now it's, it's matured and it's grown because the bad guys have figured out that there's money to be made here and in, especially in healthcare, because think about this for one second.

If I have to divert patients, what's the impact to the patient? That's the thing that we're not measuring. And I think that's what the article in that research brings to light is we need to start looking at this from a different lens because of the way that technology is so deeply ingrained in how we deliver patient care.[00:33:30]

What are the mortality rates related to, if the EHR is not available. How do we start to quantify that? So I think it's good now that's out there. We're having a conversation. I know in certain circles that I'm running in, we're starting to have deeper conversations about what ransomware means to the mortality rate.

Bill Russell: That's all for this show. I want to close this out with a couple of thank yous. I want to thank you, our listeners for being a part of the show, being a part of the community. We develop the content for you to keep you current and we appreciate you coming back to us [00:34:00] to stay current in what's going on in health IT. I want to thank my staff. I want to thank them for selecting these episodes and all the work that they do throughout the year.

I really appreciate them. I used to do this whole thing by myself and now I couldn't possibly do it all by myself. We produce way too many shows. And are doing way too many things in the industry. So again, really appreciate the staff and all the things that they are doing. And we really appreciate our sponsors.

We could not do this [00:34:30] without our sponsors. That is how we fund all this work that we do. And they have been phenomenal this year and we really appreciate them. And we're looking forward to welcoming a handful of new sponsors next year. It's going to be a fun year in 2022 As I said, that's all for this week.

If you know someone that might benefit from our channel, from these kinds of discussions, please forward them a note, perhaps your team, your staff. I know if I were a CIO today, I would have every one of my team members listening [00:35:00] to this show. It's conference level value every week. They can subscribe on our website thisweekhealth.com or they can go wherever you listen to podcasts, Apple, Google, Overcast, which is what I use, Spotify, Stitcher. You name it. We're out there. They can find us. Go ahead. Subscribe today. Send a note to someone and have them subscribe as well. We want to thank our channel sponsors who are investing in our mission to develop the next generation of health IT leaders. Those are VMware, Hill-Rom, StarBridge Advisers, Aruba and [00:35:30] McAfee. Thanks for listening. That's all for now.