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Today on Newsday.

Now, let's jump right in.

to Newsday. One of our final shows of this season and a repeat with Jason, which is great because One of the things that Jason and I were just sharing is, I think this is Jason's third month in a row of doing Newsday, and we're both at home recording this session. It's amazing. With some really good perspectives on data, which is obviously right in your wheelhouse.

But the trends and the challenges specific to integrity and security. And so Jason, I want to jump right in. One of the things we'll talk about first is healthcare data management did an article about the critical condition that the delicate state of healthcare data. And to me, this was really about the key challenges that we're facing.

Yeah I gotta say it's a put me down memory lane a little bit because the article calls out Dr.

Myself and a few others said that can't be, so we decided to put on a chapter event. and then one of the people, so who should we try to get to be keynote speaker for this new chapter we're going to create? And I said, I pull up modern health care and it was number one, most powerful persons in health care was Dr.

They're going to be represented there, all seven of the CEOs. And he said, okay, great I'll show up, which was like, oh my gosh, we just got the most powerful person in healthcare to a local national IT incident. So what did we do next? We called the seven Rios and said, hey, by the way, we'd like you to join a panel that Dr.

Braylor is going to talk. He's expecting you to be there. Please come. So we got all of them, plus John Halamka, Dr. Halamka. And but you go back 20 years ago, hundreds of billions of dollars have been spent. Meaningful use, Obamacare, all this information that's now digital which is, I think, important, but at the same time, we haven't moved the needle with respect to what the idea was originally at all.

I feel like maybe the last 20 years, we just have to get to this point. And I really frankly would never have said that until the last year or two. So I feel like actually at the precipice of a transformation for healthcare. And I can tell you, I've never said anything like that.

I just never believed. That we would have that, but something's changed where our industry is, I think, ready for adoption, ready for a change in a very positive way. And we wouldn't have gotten there, or we wouldn't be there in that position if it wasn't for all the data to be digital like it is now today.

But I feel like we're actually right at that edge of a major massive change for the better.

To me, it's that moment of now what, to your point? We spent, billions of dollars to get all of this information digitized to have the vision from people like Dr. Brewer, which was huge to say, this is what we're going to need.

Maybe not realizing the explosion of information that would continue to filter into these organizations. So you've got data coming at you from so many different sources and how you stratify that information and how you make sure it's accurate. Now, how are you protecting it against the bad guys? Meaningful use was a huge win in terms of how we are able to utilize.

It actually has added a burden in some cases, because what data do you include for the physician to review? When I think about what Clearsense does in the industry, how are you helping your clients make sure that There's accuracy in the data that's being utilized so that providers can confidently use it in clinical decision making.

Yeah, so the way I think of data and revitalization of data, the terminology we use is we revitalize your data for other use cases. And so the way we think about it's got to be timely, complete, and accurate. And so timely as in. The last 20 years of data and also, near real time data.

From the answer to your specific question, so we have lots of different validation methods to make sure it's accurate. One of the methods actually, we're about to press release this, we just got, another certification from NCQA, which is the National Community Policy Association. For their DAV Data Aggravation Validation Certification for FHIR and CCD.

So we just got this in the last couple days. And this is on a series of other DAV certifications, but it really is a NCQA saying that we have gone through the process of rigor to show that the data that came from Allscripts, Athena, Epic, Cerner, whatever it is, Exactly matches this ending spot.

Which is going to be a win in terms of the ability for people to trust what's then being handed off. When you consider the certifications or the level of intentionality that you're placing on the data, and the usability factor.

Because one of the other, articles we uncovered is, Hey, what's the integrity and ability to utilize this effectively even look like? There's this culture shift though, that you mentioned that's, been a result of the last 20 years. How do you help inform that? And from the perspective of what culturally needs to happen in organizations for the maximization of all this information coming into their EHRs to be useful all of the time, versus just in these like spot scenarios.

Some of them are homegrown EHR systems. Some of them are Systems that are in the process of being retired, a lot of them are going to Epic, some are going to Cerner, but, most are going to one of those two, obviously Epic being number one for that slotting, but you still have this data.

And there's a huge amount of costs associated. with maintaining those legacy applications. But the data is critically important. It's also regulatory compliant. And I've yet to see a health system that wants to take all of that data and put it into Epic. Because you take, the last two, three years maybe, I've seen one client that does five years.

And it looks like they're still in EPIC, but they click the tab and it actually launches our UI into our One Clearsense platform. And it shows that John Smith and all the data for the last 15 years right there. And they can search, they can slice and dice on the data for any questions that they might have across anything in their prior history.

But for the user standpoint, this is so important. And by the way, this is the heaviest usage of all of our applications is that security use case. By far above any ERP systems for decommissioning or financials, et cetera, of operational systems. This use case is by far number one. And it's because the clinicians, when they're, taking care of their patients, they need to see more than the last couple of years.

And it also needs to be one place for John Smith, not, I've got Allscripts John Smith, I've got Athena John Smith, I've got Cerner John Smith, and I've got Mennon John Smith, etc. And so it's got to be really easy, simple, and immediate, and accurate. So not much to ask for, if I'm the clinician, because their time is money.

I played golf with a guy over the weekend, and He said he saw 30 patients last week on one day. These people don't have time to be waiting and trying to sift through data. They need it right now.

In any case it's critically important to be accessible and accurate.

Yeah saw the stat that I had to double click on it.

I was blown away. It was the stat is at 67%

Healthcare organizations in the past year have had a material successful ransomware attack on their network. Not that they've been attacked. It's actually had a material impact to their business. I think it's probably a hundred percent that they've been attacked, but 67 percent of them have actually had it successful and had a major event because of ransomware.

Ransomware attack I could not believe it was that high, but it is. I've talked to CIOs over the last couple of weeks and they're like, yeah that's spot on. So what's the reason why? I think one of the reasons why is already, you have, like I said, homegrown EHR systems and you have legacy applications that are still sitting out there.

So when we go into clients we identify and prioritize not just the costly applications, but also the ones that are most at risk for cyber attack. Because these are the, anywhere from the access database underneath the doctor's desk. Bill thought he was going to make 10 billion, 20 years ago, but it still sits there hunting and finding those. But also, all the way through the decommissioning, actually, even to the point of where we're starting to get into helping our clients Take the gear out of the data center and wipe it and remove it completely. It's all the way through. Because that's how you actually will mitigate your cyber threat.

And you're moving into a high trust SOC2 certified cloud system, which is ours. So that's an obvious thing to do. And table stakes.

It is table stakes. And here's one of the things I consider as a consumer. If we know that health care is one of the most attacked surfaces. That we consume.

There's a level of self governing that's also the responsibility beyond these protocols. When you add that element of best practice and self regulation into how you help connect with your clients and the consumers, what comes to mind for you?

First of all Chuck's a great guy. I love Chuck and he's his modeling career is really taking off.

So now that Yellowstone is slowing down.

He became a, like a Western model after Reno. It's so great.

It's a Western model with a thick Boston accent. And Renown is a great buy in, of course, since for a long time, too. answer, your question now is what specifically?

Yeah, there's government standards, there's the self regulation, best practice.

Yeah, to me your CISO is so important. You have to everything's a balance but your CISO is really important.

They need to have need to have a strong voice inside any company, regardless of its healthcare. Reality is that there are companies out there that are HITRUST certified and maybe don't have the level of rigor that your organization would expect. I think to me, high trust is the bare minimum.

It just shows that you have an external body that's reviewed your policies, procedures, and you've got evidence that you meet these certification standards. But I have a lot of respect for the organizations that I've worked with over the last 30 years. that put another layer of scrutiny on top of that.

So does that CISO have the. The ability to say, hey, I just identified 150 apps that I know that this chairperson really loves this app, but it's actually fraught with, cyber threats and things of that nature. So I think that the CISO needs to have a strong voice within the health system to not just obviously look at vendors and make sure they're high trust and SOC 2, et cetera, but also internally too.

Is that health system running at a place where, you're protecting your patients because, you have a an attack. it's incredibly damaging. It's not just the 300 a year or so you got to pay to the patients for the monitoring over the next, couple of years.

And it wasn't because of a system failure. Most of those failures, I bet, are human related. But how do you rebuild trust with patients and providers when there is one of these events?

so first of all Clearsense is not a IT security advisory firm, but we have an ecosystem of partners that we work with that we trust and we recommend.

And we often are asked You know, for this given situation do you have a partner that you would introduce to us? And so , we commonly are asked that as a partner with them is to help them identify organizations that we know and we trust and we've worked with for a period of time.

It's actually another app rat opportunity as they actually buy multiple versions of this and different companies, but why do you need that? Just have, one or two really good ones, but in any case we typically will bring in a partner and work alongside them, help prioritize those applications as a part of our overall program approach.

I think that's, you bring in the experts, particularly when it's like IT security you want to bring in the people who live and breathe that every day.

And you've got the breadth and depth to say, I have vetted these third parties because that third party is where most of the challenges came in this year.

To the health systems using Clearsense. They know that you've already done your homework on. Yeah, we're not

it's our reputation, too So and these are relationships or clients are very long term. They're you know, five ten years or longer so We want to make sure if we're going to introduce a partner, whether it be for application rationalization consulting or IT security or decommissioning the actual gear.

We're not actually sending our Clearsense employees to the data center and pulling out the data. We're actually going to partner with someone. So we have a group of partners that we're building and growing. That are experts in these areas and, it's important to, have your own brand reputation to, and be surrounded by those best of breed organizations too.

And even though it seems like sometimes that might be a waste of money, if you need to get an expert's expert in to help you carry a budget expense forward, because, these things are not, so first of all, it's very expensive, but secondly your reputation is at risk if you don't actually move the ball forward with having an independent voice.

So sometimes. It's helpful just to bring in these consultants to help you get certain things passed. And at least, worst case scenario is that they still say no, and then if something happens, you can say, Hey, I, I did everything I could. I went all the way to even getting an independent voice in here to make a suggestion change.

And a lot of these, it takes. balance and it takes it's fungible.

More and more often from CIOs, we are hearing and CISOs about the importance of the shared risk with their partners. So we bring you in to help us with our data platforming and we want a sense of shared risk. What's that reciprocal evaluation?

So if you pick up a client, can you say. Dumpster fire over here. And until you do these 10 things, this is your risk score, and we accept it together. How have those conversations evolved over time?

the reality is that I'm able to then say, okay, as long as you do these things. Then I'll do this because and I think these are not for our business. We're not doing vendor kind of relationships. These are not project based. We're more long term solution partners. And there's a very big difference.

It's not just words of vendor and partner. I really mean there is a big difference. So if you're going in to just do a project and we just don't do that. You go in and you go out and you're done and we just don't do that type of business. Versus a partnership to say, I need to decommission 150 applications over the next couple of years.

Okay, great. That means that in order to do that, these are the things that need to occur. We need to have a governance board set up that will, that we can run it, if you'd like. We need to make sure that we have resources lined up to do data extractions. We can do that if they would like. They can do it, or we can find a partner to do it, whatever the case may be.

And let's make sure that in order to do that, you have to have the supply chain of all these applications. Prioritization, the data tracks. The operating model so that when we as the SaaS company are constantly being fed. And yeah, I'll take risks on that. If you're not going to do all the things I just said above that, I'm at risk as a company.

All those are ripe with opportunity, but it really does take a comprehensive solution, a turnkey solution versus only. Doing the actual SAS component, which is one piece of this goal.

And yet. The DCOM and app rationalization, huge aspect of really ensuring that, heck, a system is set up for efficiency, excellence, managing expectations.

They're also going to lean into you when they're bringing new solutions on board, whether that's making sure that there's standardized data exchange like HL7 or FHIR that enable the systems to exchange data efficiently. Thank you for listening. What does it look like when they're bringing new systems on board?

How does the conversation change, Jason, when it's bringing new systems in as opposed to decomming them?

Yeah, to us it's all the same we like to go as upstream as possible. So we're not just waiting for the next set of applications. We're actually, in some cases, we're actually doing the extraction itself.

And we're even running the governance board or part of the governance board that's prioritizing the apps that we know in three or four months are going to end up plate to do the actual application reporting and things of that nature. So we like to go all the way upstream, so there's no surprises.

These are the applications that that we see are redundant. That need to be absorbed into the overall portfolio. And I always like to say there's some CFO that's sitting down on some spreadsheet that has said, if I acquire this health system, I get to take out this cost. And so what we like to do is go all the way up to that level to say, and you'll have it out by this date.

So that they actually can rapidly take that cost out at the point of acquisition, they can see, okay there's things that we can do, we can start reducing seats off of this particular application, even before we decommission it, because you can start saving costs way upstream before it even gets to the SAS.

So we like to go up as far up as possible upstream.

Because there are so many mergers and acquisitions. What's the best point in time to be having the conversations like what you just mentioned? Is it part of due diligence? Is it the immediate post closed transaction? I've worked in orgs where we waited a really long time to do integration.

I've also worked in organizations where we did it too soon because then the deal actually didn't go all the way through or we decided to buy some of the strategy. From your perspective and the things you've seen, when is the best time to really be doing that analysis?

In our partnerships, we're part of the M& A organization of the IT team.

You can use that due diligence. And we have some newer partners that we're talking to actually that are just exclusively doing M& A and helping maximize the cost takeout earlier on. Part of the reason why you do a merger acquisition is because you actually get a synergy, what they call it, synergy.

So those are synergies. It's start with software and infrastructure costs. Obviously headcount is a part of that too. Okay. or re employed as headcount versus other things is what a lot of people do. But I'd say be aware of it, that there's some things coming. And then, just making sure that we're all talking on a regular basis and there's no surprises.

The vendors are really important to not be surprised too, because you're depending on that vendor or the partner to, they're going to actually come through on those cost takeouts.

Because there's a curve, even post consolidation, rationalization, and archiving, and utilization. Data. Management does not have an end date to it. And so as you were working with your clients and setting appropriate expectations for the right level of cost management, for lack of a better term, to put around going data programs, how are you planting that seed with the CFO so that the chief data officer.

The CISO, the CIO can have that informed conversation and also raise it to the board. You've done this M& A for this reason, but the cost of you making sure that your data is secure and operable and usable in a clinical setting and beyond, this is what you can expect post merger as an example.

there's a couple elements to what you just said, Sarah.

And then we have a called implementation fee, where we have our data engineers and our data architects are actually working to move the data from source system to our cloud and but pre signing up for that level of effort for how many applications concurrently that we'll be doing.

There's a, different prices if you're doing 10, 15, 20 apps concurrently over a period of time, one year, two years, three years, whatever the case may be, but just having that agreed upon upfront. And when we signed the contract is really important because if you have a bogey of 150 applications you need a plan of how you're going to take them out so that there's a cost to the applications you're shutting down, but there's also a cost to us too and you want as much.

we're going to bring to bear.

Here's how many applications that we need to be served up so that we're constantly working over the next year or two or three years, whatever the case may be. And they know exactly what they're spending with us up front without having surprises in the back end from us. And then at the same time, what that does is it gets their budget right, our budgets are right, we can staff appropriately on any given client.

But it really sets the stage from the get go on the strategic nature of what we do on that particular solution.

I can tell y'all have been listening. Whether it's to Newsday or anything else that's out there in the industry, and here's why. What we hear over and over again, in addition to what we shared previously, here's what CIOs and CISOs need from their partners.

They need an understanding of the governance of the process of the information. So you've shared governance of data. Predictable spend. Imagine that. How much is your solution going to cost me? And where are the biggest efficiencies going to be gained? Acceptable and shared risk. Not all partners come into the equation saying, if you do these things, we'll accept this level of risk with you, which is huge because you're helping them inform what level of spend they may want to have or processes to get to a certain point, and then understanding what those milestones look like.

Yeah I concur on everything you said, Sarah. we have a client right now that's, going through a merger and it's a huge cost to them. And they're, we're having conversations about, hey, if you can move faster, in a clearer sense, maybe we bonus you for that work and because we have unlimited scale just because of the way our model works.

We have unlimited scale. I was in a interesting thing I wasn't expecting. I did a focus group at the CHIME fall Forum, and we had a round robin of CIOs, and one of them, I won't say who or the vendor and all that, of course, but CIOs said that such and such vendor always has staffing constraints and can't seem to, do the one year project.

We're not just scampering to say, oh my gosh, you have more applications and let's go do all those right now. And just, I'm trying to whack a mole. it's just running a good operational business and knowing up front what the work is going to be and as things change, you modify those things and having a nice transparent scorecard in terms of progress towards that.

That's the only way to, have no drama kind of environment. You really need that collaboration and transparency.

And the CIOs are talking to each other. If I was going to go into business with you prior to doing that, I could get a whole bunch of benchmarking reports, or I can just call five of my peers and they will tell me the truth.

Our name on a slide, or you put us as a reference, know that we will check it, a perspective. And that's how you'll garner, how you're building all that.

Whether you're asking for the reference or not, they're going to

call their friends. They're going to be in a text chat. It's going to say, Jason and Clearsense.

They're going to be like, it's going to be a thumbs up or a thumbs down. Regardless of what

class says, class is great too. We're partners with class like everyone else is, and class is great. They have a great need. But the reality is that peer network is instrumental in picking the right partners.

This is the easy button. I think it's AI. It's I'm personally, I came in very skeptical over the last few years because we've had so many different, buzzword du jour, whether it be big data, massive parallel processing, blockchain, like just, all these things over the last several decades and just none of them have really panned out.

I really, I think that AI is different and and for us, for a clear sense, What we're now launching next year, early, very early next year, actually, is a tool where we can do AI validation. So we can build that healthcare data link for the health system, and then they can go buy whatever AI, they can buy the BYOT.

I do think that patient care related AI is going to be really important. further down the road. I don't just generally speaking because of the obvious consequences if you do that wrong. But I do think that there's going to be a ton of synergies and operational improvement from AI, and we're glad to be a part of it.

Yes, and a phrase that I uncovered last week, and maybe it's more than a week old, and I was just latching onto it was, Data distilleries. I was like, you gotta be kidding me. So I said, what's the difference between the lake, the warehouse and the distillery? And it spit out all the different perspectives, but don't be surprised if that word starts entering people's vernacular this next year too is tell me what to do with my data distillery.

I guess you're saying non business. I'm focused on my own personal health. I'm trying lots of new, different things. I've always been into sauna, both infrared and traditional. I like to weightlift. I'm going to go skiing in January. It should be great. Over in Breckenridge but I'm focusing on my own personal health.

I'm going to try some red light therapy. If you've ever heard that's promising more to come on that. But just trying to get, I'm 53 now, so I want to stay young and focus on all those things. I also would like to improve my golf game, but , That's another story.

I can't imagine a person better informed to be having those conversations and telling us next time we chat about that journey of how are you bringing in Yeah,

focus on your gut health is, I think your gut is right at the pinnacle of I'd like to see more traditional Western medicine adopt some of these other holistic perspectives on fermentation and gut support and those kinds of things.

So that's on my personal side.

If you haven't read the book, Outlive yet it's pretty fascinating. He was a guest, Peter Edia, on the Huberman Lab not too long ago, but also it's just a really good view on exactly the things that you're talking about. How do we live a longer, healthier, happier, independent life?

Outlive. I'll take a look at it.

Outlive. Thank you for joining us again on Newsday. I always love the perspectives and things that you're doing at Clearsense. I also appreciate your partnership and the perspectives that you share with our audience because When you don't know where do you go and ask the right questions this is one of the formats that makes that possible.

You too. Happy New Year.

Thanks for listening to Newstay. There's a lot happening in our industry and while Newstay covers interesting stuff, another way to stay informed is by subscribing to our daily insights email, which delivers Expertly curated health IT news straight to your inbox. Sign up at thisweekealth. com slash news.

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