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December 10, 2021: Welcome to one of our End of Year Shows. Bill gives an update on what’s coming up for This Week in Health IT in 2022 plus a chronological look at the healthcare news that shaped 2021. The biggest stories were the pandemic, cybersecurity, diversity, equity and inclusion, the change in government and the vaccine rollout. He also looks at telehealth, patient centric interoperability, 21st Century Cures, the HIMSS, HLTH and CHIME conferences, price transparency, information blocking, care moving to the home, the labor shortage and remote work culture. Hope you enjoy! 

Key Points:

00:00:00 - Intro

00:10:00 - The pandemic is the story that shaped all stories

00:14:15 - Healthcare systems took a significant financial hit in the months that they couldn’t do elective surgeries

00:19:50 - We made a significant number of mistakes in terms of marketing the vaccine

00:38:20 - Rural healthcare is set for a lot of progress in 2022


What’s Next for This Week In Health IT in 2022?

Episode 470: Transcript - December 10, 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] Thanks for joining us on This Week in Health IT influence. 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've said that about 250 some odd times this year. So I pretty much have it memorized. We're excited. This is one of our end of year episodes. Special thanks to our influence show sponsors Sirius Healthcare and Health Lyrics for choosing to invest in [00:00:30] our mission to develop the next generation of health IT leaders.

Here is what I'm going to do today. There's no interview for this show. What we're going to do is we're going to do a handful of housekeeping. I'm getting you prepared for the changes at This Week in Health IT. I'm going to cover that in a little bit of detail. I'm going to give you an idea of our production schedule for December. This is one of several end of the year episodes, and I want you to be aware of those. I think there's a bunch that are can't miss episodes. Gonna be fun. I'm going to go through 2021 and [00:01:00] reminisce and just stream of consciousness share the headlines that we've covered. We've done 240 episodes on the Today show. And the bulk of this conversation is going to be me going through the year. I think you'll be surprised what stories actually happen this year. You know, when you look back and you're like, oh, solar winds happened in 2021.

Well, solar winds actually happened in 2020. Haven ended in 2021. That might have escaped your consciousness that it actually happened in 2021. January is when we covered it. So we'll go into some [00:01:30] detail on that. So I'm to reminisce throughout the entire year of the stories, which dominated the headlines.

And finally, I'm going to thank a few people that have come on the show towards the end of this, and really appreciate them making this show what it is. All right, ready? Here we go. For next year let me give you an idea of what we're going to be doing on This Week in Health IT. We have four channels. So we're going to have four distinct channels on iTunes, on Google play, wherever you listen to podcasts. Those are [00:02:00] This Week Health News This week health news is where we cover the news. And it is our Newsday show and it is our Today show. So anything that is about keeping current on health IT that's where it's going to be. That's our interviews in action when we are talking to people from the floor that is going to be in our news section.

So news is about current events. What's happening. What's going on right now. The next show we are going to do is This Week Health Conference. This show that you're listening to this influence show is going to [00:02:30] change next year, and it's going to be called Keynote. We're going to do 52 of them. We're going to be doing it with people that are the kind of people that you would hear at a conference as keynote speakers.

The goal with this week health conference is to create a conference that goes on all year long. And we're going to have this show, the Keynote, we're going to have solutions showcase. That's going to give you a feel for which products are up and coming, and which products are making a splash.

That'll be the equivalent of, I guess, walking the floor and going to see all the product [00:03:00]presentations and those kinds of things. We're also gonna do some other things. We have campaigns that we do from time to time. Those will go to the conferences as well. Those campaigns are generally around a topic.

They'll be around things like ransomware, cloud, cybersecurity. They could be around you know, some aspect of data and analytics, AI, you name it. But those campaigns generally are short burst episodes. 10 to 15 minute episodes followed by a webinar. So that's going to go in conference.

So we have this week health news this week health conference. Let me tell you [00:03:30] about the two new channels that we are launching. The next one is this week health community. So this week health community is just that. It's about our community. And one of the things we were trying to do in that channel is we're trying to get a little deeper dive into some of the topics that you are interacting with on a daily basis.

And the first show we're going to launch in that is called Townhall. These are 10 to 20 minute episodes. They're going to air on Tuesdays and Thursdays. And this is the first time we are inviting guests [00:04:00] podcasters, if you will. And so we've sent out some invites to people and we're asking them to tap into their network.

So we have some CIOs who have agreed to participate in that. We have some data scientists, clinical informaticist, CMIOs and our hope there is that they will tap into their networks and talk about some of the topics that we are dealing with at a level that you are interacting with them on a daily basis.

So this is more the deep dive on subject matter. And it's also a place [00:04:30] where you can get a lot of different perspectives. So you're not just going to be hearing from me. You're really going to be hearing from a lot of guest podcasters. So this week health community is about you sharing your best ideas with the community.

And then finally, we're going to close it out. We have this week health academy. This is our IT university. This is where people go, who want to get up to speed on what's going on in healthcare and in healthcare IT. These are people who are new to healthcare. These are people that are looking for a platform to help mentor.

I've talked about this a little [00:05:00] bit. How I would use this, if I were a CIO today, I would use this for two things. One is a lot of, you have told me that when you hire somebody who's new to healthcare, you plug them into our channel and they listen and they come up to speed very quickly because they are listening to some of the best and brightest people in healthcare talk about the issues that are top of mind. So they, they immerse themselves in the industry and they can still do that on conference newsroom and community. But this week health academy is specifically [00:05:30]designed around education. And so what we're going to do with our Insights show right out of the shoot is we are going to go back and pull highlights from the first four and a half years that we have done the show and we are going to package them up in about 10 minute episodes in a show called Insights. It's going to air three times a week. And again, here's how I would use this. I'd use it for people who are new to the industry. That's one thing. The second way, I'd use this as for a mentoring opportunity. If I were mentoring somebody, I would [00:06:00] listen to this channel with them and have the conversation. You might say, well, Micky, Tripathi says this about interoperability.

Let me tell you what we're doing with regard to interoperability, or we've heard Craig Richardville talk about cloud computing over here and how they're doing it at SCL. Let me tell you how we're thinking about cloud computing within our health system. So I think it's a good platform. We consider IT university.

We've decided not to use the university name, but to stick with this week health academy to communicate that this is about [00:06:30] education. So we're going to have four channels. The four channels are going to be distinct within iTunes. So if you subscribe to one, you'll get the content from one. If you subscribe to all four, you will get the content from all four.

If you want to subscribe, go to this and it's actually right there on the front page, but you could also go to our shows page this weekcom/shows. It'll have a description of each one of the channels.

And I have a little description of each one of the shows that we are going to be doing in 2022. We're excited. This [00:07:00] represents a significant growth for us and it's something that we had a vision for a long time ago, and we're looking forward to sharing it with you as we move forward.

Before we go to the chronological look at the news. Let me tell you about our production calendar for December. There are five special episodes that we've produced. Most of them I've already recorded. So I know they're very good. I've done two shows with the advisers of this week in health IT. If you're wondering who my advisors are there, Dr. David Bensema, who has been a friend of the show since the beginning. Anne [00:07:30] Weiler who has been on our Newsday show, she's phenomenal as well. Sarah Richardson has been a great advisor and has helped us to map out our growth strategy.

Frank Nydam formerly with VMware now with Tausight is another one of our advisors. And then Dr. Lee Milligan is an advisor as well. And this group of people has really helped to shape the show and to shape the content that we are delivering to you. And for next year, they're helping to shape the events that we are putting together as well as some [00:08:00] of the other new offerings that you're seeing.

And so, they keep me sane. They keep me on the straight and narrow. And they keep me focused on what is going to provide value to you, the community. Well, we did two shows with them. Broke it up. And we asked them to take a look back at 2021. What are the stories or events that shaped the year?

And we ask them to take a look forward and what will shape the year that is 2022, that's coming up. These are great shows. And again, I'm looking forward to sharing them with you.

This show is the chronological look at the [00:08:30] news and that's, that's what we're going to be doing today.

This is one of our end of the year episodes. And then we also have a look at the Newsday conversations that we've had with this year's guests hosts. As you know, the Newsday different from today. Today is me just talking about the news. The Newsday shows me and other people having a conversation around the news.

So we have a little different perspectives going on around. My team has picked their favorite moments from the news day show. And I've thrown in a few of [00:09:00] my own, and there's going to be a news day compilation. What we've chosen as the stories which had the most impact we believe had the most impact.

So we're going to cover those in a compilation. And then finally you're going to meet the team. So I'm going to have my team, this weekinhealthit team come on the show and share their favorite moments from the interviews that we've conducted this year. This is going to be fun to get their perspective.

They are becoming healthcare insiders, but they're not yet. Most of them have been in healthcare [00:09:30] for a year or two. And many of their stories that they picked are based on their personal experience as consumers of healthcare. So that should be fun. All right. So that's what we're going to do through the end of the year.

You know, our today's show, we do one week of shows in December and then that's it. We won't pick that up again until early January. We take a break from producing new shows at the end of the year to prepare for 2022. All right, let me do the chronological look at the year [00:10:00] that was 2021. So clearly the story that shaped all stories is the pandemic. And we are going to come back to the pandemic over and over again. Again, I'm going to do chronologically some of the stories that we covered. So, you're going to hear me come back to cybersecurity a couple of times, come back to the pandemic and where we were.

Let me remind you of where we were in January. Obviously the pandemic is the story that shaped all stories. The second story that shapes the stories is the transition in [00:10:30] government. So we have the Biden administration coming in following the election and in the early phases, it felt like what it was going to be is anything the Trump administration did was bad and we have to overturn everything that they did. Now that sort of mellowed from a healthcare perspective, as things started to move forward and we saw the continuity start to take shape.

But early on it was believed that, you know, just about everything that the Trump administration did was wrong. And so we had to keep an eye on that. Where was the [00:11:00] new government going to take healthcare? Where were the policies and the regulations going to go? Who were they going to appoint and to keep positions. All of that stuff was pretty important.

But let's go back to January. In January. We didn't have a lot of the vaccine. And we had a long line of people that were ready and willing to get the vaccine once it was out. Now, the vaccine had been developed, but we just didn't have a significant supply. So early on in the year, we covered stories around [00:11:30] how we were going to communicate how people could get scheduled, where they could get the vaccine.

You know, how long of a wait they could expect. We had blocks of people that could get the vaccine and blocks of people that couldn't get the vaccine. So I remember in January, I was saying it'll probably be until April until I could get the vaccine. I think I got it earlier than that. In fact, here's my vaccine card.

Let's see. I ended up getting it in March, actually. Last day of March is when I got my vaccine. And, you know, but in January it wasn't even an option for [00:12:00] me to get the vaccine. So the vaccine and the low supply people waiting in line to get it.

And we just had logistics challenges. A lot of those kinds of things. Let me run through some of the headlines we had here. The second story of the year that we covered was rolling out the vaccine and how much of a huge challenge it was going to be. Some of the tools did not exist from a scheduling standpoint.

So we had that challenge. We had the challenge of follow-ups and those kinds of things. So that's one of the first stories that we ended up covering. The second story we ended up covering was Havens end. [00:12:30] So Haven, the JP Morgan Amazon Berkshire Hathaway partnership came to an end and we talked about why that was. And my supposition here was that it came to an end because you had significant cultural challenges. Leadership never really fully committed to the direction.

One of the things that Anne Weiler and others commented on the show this year is Atul Gawande held like multiple roles. He wasn't truly the CEO of Haven. He was the CEO of Haven as on a part-time [00:13:00] basis, which seems to everyone that it would have been a full-time job.

So there's a lot of challenges. Whenever you try to build those kinds of partnerships, it is very difficult to to pull off because you have conflicting cultures and potential outcomes and those kinds of things that are the expectations of the actual partnership. So that that came to an end. Healthcare made some of those normal comments that we make. You know, this, this shows how hard healthcare is.

I'm not sure that end, did show how hard healthcare is. I'm not saying healthcare isn't hard. [00:13:30]I'm saying that that end was more about the fact that they never really got started. And we took some of the wrong lessons out of that meaning that, you know, these people are going to go lick their wounds and sure enough Amazon was full speed ahead from the minute this was announced as the end. And we have a couple stories on Amazon care and its expansion moving through the year. So that's January 5th. We talk about a couple of acquisitions during the year. We have Optum acquires Change healthcare. There's going to be more as, as the year goes along. Then we went to the JP Morgan [00:14:00] conference.

Actually, it was a virtual conference this year, so we didn't go to San Francisco. We sat right here in my studio and watched 24 CEOs and CFOs get up and talk about the year that was 2021. And we covered some of the some of the highlights from this. Two highlights. I'll give you one is there was a significant financial hit for the two months where we did not do elective surgeries and that impacted healthcare a little differently across the board.

[00:14:30] There's the haves and the have-nots. If you were struggling financially, when you took that two month hit, clearly things got very bad, very difficult for you. But if you were a large health system with, you know, multiple billions of dollars in the markets it was a blip. I mean, it hurt. It wasn't, it wasn't insignificant, but it's the kind of thing that you could weather and move on.

So, there was that financial aspect. The other two things I highlighted, which I think were worth taking a look at one is more than half of the [00:15:00] CEOs got up and talked about cybersecurity. And I thought that was a huge movement for us. if you're a CIO or if you're in IT you know that for years that was an uphill battle.

We were trying to push that stone uphill to get people to recognize how important it was to invest in cybersecurity. It was sort of like, yeah, we'll give you money for it, but it's you know, you know, try not to spend too much or spend it effectively as they always want us to do. But the reality was it [00:15:30] felt like we were pushing the stone uphill.

You had a number of incidents that happened in 2020, which sort of changed the the calculus on that. And it was that hospitals were getting shut down .Completely ransomware was taking down hospitals completely. And obviously we'll talk about the event at Scripps which happened this year, which was if the CEO's hadn't woken up at the JP Morgan conference, they'd definitely woken up after the Scripps event [00:16:00] and recognize that cybersecurity is a top of mind strategic issue for every health system.

The second has to be diversity, equity and inclusion. The health equities came to the forefront during the pandemic and every CEO got up. And you also had the events, George Floyd and other things that happen during the end of 2020 that led every CEO to get up and talk about what they were doing as a health system, how they were addressing health equities in their communities [00:16:30] and whatnot.

So those were significant stories at the JP Morgan conference. The vaccine credential initiative became something that, we're still in January vaccine credential initiative became something to keep an eye on. I decided not to focus in on, you know, vaccine mandates and showing proof of vaccine and all that other stuff.

What I decided to do was to focus in on the IT aspect of this, which was the vaccine credential initiative proved interoperability works. And specifically it proves patient-centric [00:17:00]interoperability works. Right. So VCI was about collecting information about your vaccine. Getting rid of this card, right. So putting it on an app on your phone that could go out there, query the databases that be, that have the information and then validate that you have your vaccine so that you could show it at an airport.

You could show it wherever you're going to show it. And again, I didn't focus on the civil liberties or the health aspects of everyone getting their vaccine. What I was focused on is I, I believe [00:17:30]that patient centered interoperability is going to be one of those things that changes healthcare. When we finally get the information in people's hands and they can determine how they're going to use it.

So for instance, this year I bought a whoop and I'm wearing the whoop. And I really like it. I'm getting a lot of really interesting information on my sleep and my recovery and those kinds of things, but it would be interesting if I had my information that I could provide to them and they could start to develop services in addition to the health that they're providing me right now.

And that's [00:18:00] just an example. They don't offer that today, but they could offer that kind of thing. If there was patient centric interoperability which ended up being a significant conversation this year, because 21st century cures although a little bit muddled early in the year. What are the dates for the required things around 21st century cures. But as the year went on and we appointed Mickey Tripathi as the ONC Director of HIT in charge of interoperability and health IT technology [00:18:30]for the ONC it became clear that we were going to stay that course.

We were going to see a continuity of thought around 21st century cures and interoperability which was welcome. Right? So this is one thing we can't have. We can't go from administration to administration and have a different view of interoperability and have it be, you know, we're going to be interoperable now and we're not going to be in four years.

This should never be an election issue. It should just be a consistent progress [00:19:00] towards getting people empowered with their health information and creating less friction between people and receiving healthcare and between providers and providing great healthcare. So patient centered interoperability.

Let's see bunch of things on vaccine distribution. We, we highlighted some of the really cool stories. Atrium Health and University of Colorado health system did mass vaccination events and University Colorado Health system created a playbook. It was a great playbook. We highlighted it on the show.

The mass [00:19:30] vaccination events really highlighted the ability to do partnerships with between public and private. So we had to make sure we had enough vaccine. So you had the the partnership with the state governments to make sure you were going to have enough vaccine. We had, partnerships with industry as well I think. The Atrium partnership was with Honeywell, if I remember correctly and they created a bunch of technology to support that. You also have partnerships with NASCAR and the NFL and major league baseball. So we used [00:20:00] stadiums and we used NASCAR tracks. I thought that was really cool.

So the Atrium event, they were able to drive onto the track, go into pit row, get their vaccine, drive the rest of the track and then out. And that's the kind of stuff I thought was really well thought out from a you know, vaccine standpoint from an efficiency standpoint and from getting people on the right track.

Right? So, Hey, this is something I want to do kind of thing. One of the things we talked about early on is we made a significant number of mistakes [00:20:30] in terms of marketing the vaccine. Yes, there is misinformation. But for the most part, we did a shaming campaign, which still goes on today, somewhat. Don't have your vaccine, you're an idiot kind of conversations.

And I noted early on that that is a horrible approach. Has always been a horrible approach. It's a horrible approach to parenting as well. And what happens when you do it as a parent, is your kids dig in and they make sure that they don't do something. And we've seen a lot of people dig in and they're not going to get the vaccine.

[00:21:00] Now towards the middle of the year, we recognize that we highlighted some of those things on the show as well. We had a systems start to put together phenomenal graphics that highlighted the number of cases in their geography. Number of ICU cases, a number of deaths in their market. And I thought those graphics were really well done.

It gave people, it, it made it real. So that was one of the things. We also highlighted some of the better marketing that came forward from health systems and it was [00:21:30] predominantly from health systems. One of the ones I highlighted was from Providence and they did a sort of a myth about the vaccine and a truth about the vaccine on either side and really addressed that.

I thought it was really well done. It was done more from an education standpoint. And I think that is the tack.

The education standpoint, the incentive standpoint that I thought early on in the year that would work well, of course, you know, time tells a different story, but that's that's what I was recommending early on in the year.

And we saw [00:22:00] some of that come to fruition and then we just flat out, told people they had to get it. And we did mandates towards the end of the year. Let's head into February. So in February we have Kaiser signs a ten-year deal with Microsoft. We saw a bunch of cloud deals and I thought that was interesting.

We had a significant conversation around events, right? So, postpone events. Go to virtual events. CHIME and HIMSS. HIMSS Postponed until late in the year. And they finally had that event in Vegas. They were twice bit, I mean, they got [00:22:30] canceled in 2020 right in the last minute.

And then 2021 hits and they postpone, they go to Vegas and Vegas is spiking right at the time they they go to, to do their event in Vegas. And so, you know, there's a belief that there's going to be a little bit of a shakeup in the conference, in the events. The side of the house H MSSI announced, I think 18,000 people, but we don't know how many people were actually on site.

We know that that's a virtual and a physical number. [00:23:00] I did go to the HLTH event in the fall. Really well run event from the perspective of everyone was tested at the event.

The only people who got into the event were those who tested negative for COVID. And because it was the state of Massachusetts, there were state laws in effect around wearing masks.

Although I will say that a lot of the conversations that happened were not mashed up conversations. I think what happened is people would come together. They'd say, Hey, do you mind if we take off the mask? [00:23:30] For the most part, people felt pretty safe there. Right? Everybody had just been tested no, no less than 24 hours earlier.

So a lot of people that lowered the masks had conversations and then went on. But as you walked around and moved from place to place, you put your mask on out of respect to other people and to abide by the state regulations that were going on. A number of people at that event was roughly 4,000 people on site.

I think they announced a little higher number, but that could also be their virtual attendance. Again, we'll see what happens. There's a big thing happening in early next year [00:24:00] we have the CHIME health partnership, the Vive event happening one week before the HIMSS event, one is in Miami. The other is in Orlando and I'm getting the feeling from people I'm talking to that people have to choose.

They have to pick sides here and decide which event you are going to go to. So it's going to be interesting to see what decisions people make around that. Plus, you know, some people are still under travel restrictions is, is one of the things we learned later on of this [00:24:30] year, 2021. And even if they had wanted to go to certain events, they weren't going to be able to make it.

That was interesting. A lot of conversations around telehealth, as you would imagine. There's a significant amount of the conversations had to do with funding for telehealth. At this time, by February of 2021, we had seen the telehealth numbers start to recede pretty significantly.

People were saying that we, you know, we need to make sure that the funding doesn't go away. The [00:25:00] funding still hasn't gone away. That is one of the things that you know, early on in the year I covered and I said that the federal health emergency would go on through the entire year of 2021, which meant that the telehealth funding would remain intact through the end of the year, which it has.

And so the numbers going down has nothing to do with the funding per se. Well, it has somewhat to do with the funding. I don't want to get into too much of the detail here or I'll get lost, but I think a lot of it has to do with culture. We're snapping back to the [00:25:30] culture that we once had. The number one indicator of, if people are going to to do a telehealth visit is the recommendation of their clinician or their physician.

So if a physician says, Hey, our next visit will be via telehealth as a follow-up visit or whatever. That is one of the biggest indicators of if they will do a telehealth visit. And so if your physicians aren't saying, Hey, let's do telehealth. That is going to drive it. Let's see, also in February.

Truveta [00:26:00] launches. Truveta, the big data platform de-identified data for the good of all mankind. This was actually one of my predictions that we would see a bunch of these launches. Truveta is a partnership. A lot of different companies coming together to share their data, again for the good of mankind.

And also I think the valuation on this thing has to be pretty astronomical at this point. And so we will see how that how that plays out. I gave three suggestions to them back on February 12th. See if they take any of them. [00:26:30] We we took a look at price transparency. Price transparency was one of those interesting things that we were all worried about early on in the year.

And then the Biden administration came in and it appeared like they were not going to enforce anything. Which is the same thing as saying, you know, don't worry about this law. It doesn't really matter. And then a little later after things sort of settled down, they reaffirmed the goals of price transparency.

So, again, a bunch of stories around this one is [00:27:00] that you know, price transparency, we had some tools come to the fore which we're collecting the information and actually producing apps that you could go out and you could see for shoppable services, how much they were in your local market.

And we highlighted one or two of those apps on the show And I think that's going to be pretty interesting. We also highlighted the fact that the rule was a little convoluted. It wasn't real clear on where you should put the information in what format was somewhat defined, but not well enough defined.

[00:27:30] And so a couple of the stories were about helping to define the structure of the data that we were putting out on our websites and the location of the data to make these tools more effective. Again, in February, Walmart's slowing down its plans for clinics, some people ran into that and said, is Walmart pulling out of healthcare?

And we go to the HLTH event in the fall, sure enough, Walmart gets up there cause they've very strong presentation. And essentially says we've been in healthcare since 1978. And we have no plans of pulling out of healthcare anytime soon. You have the [00:28:00] normal things that go on. You had some changes in leadership.

You did have some changes in priorities throughout the year. The pandemic had a way of doing that. You know, you're running down the road in one direction something happened and you had to pivot, took your focus off of let's say building clinics. And so their clinic plans are moving slower while they were focused on other things.

But in the fall they reaffirmed this is absolutely a priority for Walmart. Obviously we talked about Walmart, we talked about CVS as well. [00:28:30] And you know that the, race for retail continues. And we talked about a bunch of those things in the stories. Watson's for sale.

IBM Watson is going to be one of those cases that gets talked about forever in healthcare. They came in loud and proud into healthcare, and they chose a extremely hard pressed set of problems to try to solve. I mean, they went after oncology, they went after diagnoses and they essentially said, look you know, Watson is going to go out and read all the medical journals.

It's going to be smarter than [00:29:00] doctor, and it's going to be able to provide a diagnosis and you know, they failed in a large way within healthcare. Now I, again, in this show, this is early March. What I talk about is it's not that Watson doesn't have value in healthcare it's that there was a significant number of missteps and some bad, a bad taste in some people's mouth as a result of that.

Amazon care. So this is also in March. We start talking about Amazon care and their expansion. Amazon [00:29:30] care announces they're going to be in all 50 states for their employees.

And this continues to be one of those things to keep an eye on. So they launched into all 50 states, where are they going to go to next? Well, they're going to go to start signing other employers onto their programs. They expand to 50 states for their own employees. Then they sign the company that owns Peloton.

And now they've just signed another company towards the end of this year. So we saw significant movement here. Now, I don't know where it's going to go, but directionally, [00:30:00] you can see them offering these kinds of services, this concierge level medicine, a good technical front end telehealth visits onsite visits at the employee's location.

Medications when not shipped directly to the home or the office, wherever somebody wants to somebody wants to receive that. So an awful lot happening in the employer market. You had Transcarent Glen Tullman's new company at the end of March come out of the woods and we started to see how [00:30:30] that is going to materialize.

And again, I like it and I like it because Glen has a way of seeing the the experience and the economics and the partnerships that are required to address the problem. And when he looks at the triangle of those things what he looked at and said, look, employers are getting more and more frustrated.

They sit in front of these, in these benefits meetings, and they just get hammered by their employees. The experience isn't good for their employees. The costs keep going up for the employees. [00:31:00]And the friction with healthcare is sometimes overwhelming. And so he essentially starts to orchestrate what the experience should look like how the compensation should work and what partnerships with health systems need to be in order to facilitate a better model for health care for healthcare for employers.

And Transcarent is off with a hundred million dollar raise at this point and they're off and starting to create some value in [00:31:30] healthcare for those employers. And I think they've signed up a significant number while not significant number of employee employers, but large employers with a lot of employees, if you will.

On April 1st, I decided to have a little fun and I titled an article Google acquires Epic, and you know, every now and then we see these articles and we see these stories, you know, should Google acquire epic? Should Microsoft acquire epic? Let's get something straight. Epic is not for sale. Nor do I think it's ever going to be for sale if Judy has any [00:32:00] say in it.

So you know, and so I sort of wanted to poke fun at all those stories that continue to pop up throughout the year. And I decided to do that on April 1st. I don't know, I wonder what I'll do for 2022 on April 1st. I'll have to start thinking about that.

Let's see information blocking became a big conversation that you know, what is the actual rule?

What do we actually have to do to be compliant with that rule? And and so we continue to look at that again, Mickey Tripathi being put into the role that he was [00:32:30] put into was a great move. And we applauded that several times. Mickey was actually on the show prior to going onto this role when he was doing some work with Arcadia.

And the thing I loved about Mickey is he's like a historian of interoperability in healthcare. I mean, he can tell you what the intention was, what the misstep was. What the correction was. How 21st century cures is going to address those things. So again, it was a, I think a great move [00:33:00] to put him in that it's signaled to the industry, that it is full speed ahead.

Maybe a little different tack and approach. Mickey is very collaborative. He is very he wants to hear from you. He wants to ensure that everyone understands what is the intention. And he also comes from Massachusetts where they are doing the HIE and interoperability extremely well.

So a bunch of stories around this timeframe, the April timeframe around price transparency around information blocking [00:33:30] and we continued to cover those things. Let's see where we're at. We are in May. I jokingly I did a story on Walmart's back. Did they ever leave health care?

And so again, the news stories started to correct themselves as they went on. We talked about patient centered interoperability. Since I've already talked about that, I will go on from there.

You know, a lot of the telehealth stories had to do with, again in May, we started talking about this, they had to do with how are we going to integrate them into [00:34:00] the existing workflows and how are we going to remove the friction?

So a lot of the telehealth not a lot, most of telehealth was done via. Okay, so that's number one. Number two, the so they weren't done with the fancy technology. Number two, Zoom was the number one mode of doing doing telehealth visits for video visits. So that's number two. And the reason for that was it just worked.

They have a very good [00:34:30] platform for enabling video visits. And one of the things we found is that the failures had to do with people not being able to make the connection. For whatever reason, either the workflow was kind of convoluted or the technology that didn't work, or they were in places that were underserved from a bandwidth perspective.

And so they would fail from that, from that perspective. So we had a lot of things to try to reintegrate and rethink through [00:35:00] from a from a telehealth standpoint, to try to establish a new baseline, right? So we don't anticipate where we're gonna go back to 70 or 80% like we did in the two months at the peak of the pandemic early on in 2020.

But we want to establish a new baseline that is higher than what we had prior to the pandemic, which was almost an anaemic level. And the reason we want to do that is because access is better and because the cost is lower, but we have to think through how we're going to do [00:35:30] that. Also in May is when the Scripps outage happens.

All right. So cybersecurity again is top of mind is something we need to talk about. Scripps goes down. Here's the thing. We don't know a ton about this there. I mean, it's not that they weren't forthcoming it's that you know, maybe they weren't able to talk about some of these things, but here are the details we do have, the EHR was down for probably close to about 30 days.

They did go onto diversion. And at the end of the day, the total cost of the event to Scripps, [00:36:00]at least reported in their financials was about $110 million. So again, any CEO who wasn't aware of cybersecurity being top of mind, they were reminded at this point. And I think around June 1st we saw an article in the San Diego newspaper that their EHR was back online.

June 1st. So for the most of the month of May, they were offline from a perspective. So you ended up with a lot of ransomware stories that we covered. A [00:36:30] lot of security stories that we covered. There were some significant stories, right? Solar Winds still affected us coming into this year. We had a Azure vulnerability that came forward this year.

Obviously we have the ransomware attacks. We have the phishing attacks that continued on this year and the attacks got more sophisticated as they went on and we saw them spread around the health system supply chain and starting to go upstream. And so now we have to worry about our partners and their [00:37:00] security posture and what vulnerabilities that creates for us.

Then we did a recap, the CHIME summer forum. We took a look at the response from Chris van Gorder who's the CEO of Scripps and just some awful lot happening from that perspective. All right. So then we go, where are we at? We're almost in July.

We are in July. There you go. A lot of innovation stories and here's one of the ones I thought was interesting. Dollar General hires a CMO. So there's a [00:37:30] general belief that one of the ways that you can, well, not a general belief it's a fact that a lot of our health is based on decisions we make outside of healthcare itself. Right? So a lot of our health is determined by the decisions we make in the aisles of the grocery store. And so Dollar General hired a COO, not a marketing officer, chief medical officer, who's going to look at what they have in their store, what services they offer. And I noted in this [00:38:00] story that this is an important movement.

And the reason it's an important movement is because Dollar General tends to serve the underserved areas. And Walmart also made this case as well, that they are in a lot of underserved areas and they are a good conduit to to a population that doesn't necessarily have access to great healthcare.

And so I think that movement is going to continue. We're going to see some interesting thing happen with regard to rural health care as [00:38:30] next year progresses. Because it is top of mind, people have noticed that it's an issue. We also, one of my predictions last year was that the Biden administration would get an infrastructure bill pass, which they have a half of one at this point who knows what will happen with the other half.

But that part of that bill would go towards building out rural broadband to support things like education and to support things like, telehealth. So, so a lot of interesting things going on there. One of the things we saw is a [00:39:00] move to different care venues. And this happened in a lot of different ways.

We saw the move to the home. Obviously we had an announcement from Mayo and Kaiser in support of medically home towards the middle to end of this year. We had a bunch of telehealth stories that talked about different ways that they were delivering care and care venues. We also did stories about the pushback on the medical licensure around telehealth.

It's state-based right now. There's compacts between states [00:39:30] to allow doctors to go over state lines but in order to do that, they have to be licensed in both states. A lot of doctors don't want to do that. And there's a belief that some of this should be done at a federal level. The states are pushing back.

And to be honest with you, it doesn't appear to have enough momentum from any source of energy to change the way things are being done today. I mean, we'll see if that changes, but today it doesn't seem like there's going to be any significant move movement. Let's see, we look at the [00:40:00] COVID-19 numbers.

We did that a couple of times this year to see what was going on and see how we were progressing. It seems like we've sort of stagnated around the 60%. Each state's a little different I think based on the demographics and the culture of those states. State I'm in Florida is at 60% California where we visited with 62%.

That seems to be pretty much the norm. You have some states smaller populations Northeast that you're seeing, you know, seventies I think [00:40:30] even approaching 80% of vaccinated. We covered that a couple of times throughout the year, as you would imagine, because that's the overarching story that really impacts every story, which is the pandemic is still going on.

And I don't know, maybe we thought it would be we would be further along at this point, but it looks like the pandemic will be with us going into 2022. And we'll see where that goes. Towards the end of the year, I started going to some conferences. The HLTH conference. The CHIME fall [00:41:00]forum and a healthcare to healthcare event and started to just air those interviews.

A lot of really good interviews. We talked to Mike McNamara with Impact Health. They conducted all the testing. They have a group they essentially have nurses, they have a pool of nurses that they could call from. They pull them in, they establish the process for testing and they could stand that up.

So they stood it up for MGM to help reopen Vegas. They stood it up for the HLTH event. And they [00:41:30] can conduct a significant number of tests in a short period of time with a high degree of trust factor. So that was an interesting conversation just to hear about how they were opening places up and whatnot. Again, a lot of good conversations at the HLTH event. We then went to the CHIME fall forum, talked to a bunch of CIOs, tried to get a feel for what was top of mind. And, you know, the one thing we haven't talked about on this show yet, which was top of mind was, was labor.

We have a change in the nature of [00:42:00] work in general, which is very interesting. The nature of work you know, being remote and the desire to be remote and work from anywhere to do a job has really changed things. It's changed the way we manage people. It's changed the culture of the organization that we work for. And what we saw is a lot of people change jobs. But we also saw 5 million people leave the workforce. About 3 million women leave the workforce. And we, we continue to see record numbers of baby boomers reach retirement age. And so there was a labor [00:42:30] shortage. And so a lot of conversation around how are we going to address culture?

How are we gonna address the labor shortage and how are we going to hire the best people? That brings us about up to date. I sort of flew through the second half of the year, but that gives you an idea of just some of the great conversations that we had this year. Some of the stories that we covered.

I want to thank a bunch of people who have been a part of the show. First of all, we started having Newsday guests on the show and we've had some great people. Tony Thornton was on from [00:43:00]WWT. Dr. Collier was on. Chris Logan was on as a guest host. We had Drex DeFord who comes on pretty regularly. Anne Weiler.

The incomparable Sue Schade has been on several times. Mari Savickis was on. Dr. Q. Dr. Quinones has been on a couple of times as well. We had the Sirius people who had come on just phenomenal conversations. Karl West, and I dissected the Sky Lakes ransomware event. That was really good.

Eli [00:43:30] Tarlow was on. I'm gonna skip some people here and I apologize to anybody who I'm skipping, but we had an awful lot of great guests come on to talk about the news. And Ed marks came on. Frank Nydam came on. I really appreciate them doing that. It's interesting to get the various perspectives from people of what they thought was interesting about different news stories and even what new stories they, they selected. I want to thank the CIOs who came on this year. And again, I'm going to miss some here, but we had Jeff Sturman came [00:44:00] on. Tom Bennett came on. Theresa Meadows came on as well.

Dirk Stanley, not a CIO, but a CMIO came on. Craig Richardville, Ed Kopetsky. John Brownstein. Again, not a CIO, but appreciate him coming on. Joseph Kvedar was also on. Sarah White from university of Colorado came on and talked about their playbook. Again fantastic. Patrick Anderson, Zafar Chaudry. We had Karen Murphy, Chief digital officer at Geisinger. BJ Moore is always a great guest, incredibly smart. Becky [00:44:30] Fox from Atrium CNO talking about their mass vaccination event. William Walders came on a couple of times this year and appreciated him. Nassar Nizami at Jefferson. David Baker one of my favorite CIO's cause he's used to work for me as Saint Joseph's. Gone on to be the CIO at Pacific Dental, which is a billion dollar plus dental service organization which was great.

Kevin Maneman also from my past. He is at Providence now in charge of the Southern California [00:45:00] market. And Kevin's one of the people who really taught me healthcare. I came in and really knowing technology and knowing it pretty well. I needed to understand and learn healthcare. And he sat me down on several occasions. We went to baseball games. Angels games, which not that exciting, but because it wasn't that exciting he was able to teach me about healthcare and how doctors get paid. And what DRGs are. You name it. So we, we would just do acronym soup and he would help me to understand what everything was. Aaron Miri always a great great guests. Andrew Cooper came on. John [00:45:30] Groetelaars CEO of Hillrom came on. And that was a really fun conversation as you know, Hill-Rom and Baxter are coming together.

And so we will see what happens with regard to that as well. Reid Stephan came on for the first time CIO at St. Luke's. Jamie Nelson hospital for special surgery. Andrew Rosenberg, Sarah Richardson came on CIO's. Joey S udomir came on. Wow, just some great guests this year. And I really appreciate I guess we'll say John Halamca [00:46:00] and we'll give him an honorary CIO.

He's actually the president of the Mayo clinic platform. Cletis Earl came on as well. Now at Penn state health. Love having him on the show. Two guests, I always want to call out Rob DeMichiei former CFO for UPFC is always great. He really educates me on the financial outlook. I tell him what I see at the JP Morgan conference.

And then he tells me what I should see, which is really helpful. I mean, he has such a deeper background in finance, and so [00:46:30] sometimes I don't pick up exactly what I should from the financial presentation, so great conversation. Dale Sanders. Always wonderful to have Dale Sanders on the show.

Just knows so much about architecture and data and really the investment side as well. So great to have conversations with him. Brent Lamm came on and the university of North Carolina Associate CIO. Kristen Myers. Love having Kristen on the show another CIO. Brian Sterud was on. David Ting CTO and founder of T ausight came [00:47:00] on.

So Tausight's coming onto the scenes. Some new product coming out, very interesting. Paula Edwards and Angelique Russell, back to back episodes. Great data episodes. If you're looking for great data episodes Dr. Paula Edwards is phenomenal around governance, analytics, human centered design. And then we had Angelique Russell who's really practical on the clinical data models.

She has built those out for years, really understands them, starting at city of hope then at Providence, and now from a consulting perspective. [00:47:30] So again, excellent actually guests to have on the show. I think the last CIO we had on was Ryan Smith with Intermountain Again, phenomenal conversation.

Michelle Stansbury with chief digital at Houston Methodist also came on. Another great conversation. And I also have to thank Charles Boicey who came on from Clearsense. CTO from Clearsense and we continued our series of CIO to CTO conversations. I remember sitting down with a CTO in my office.

It's one of the favorite, my favorite things to do. And [00:48:00] I'd just throw at the CTO, you know, here's, what's going on in healthcare. How do we solve this with technology? And Charles says taken on that role for me and does a phenomenal job. I just throw things at him. We talked about the, advent of development as a necessary skill.

We went away from that as CIO for health systems a while back, and now it's coming full circle. We're starting to try to create experiences and knit some things together. And granted we're not building big systems where We're actually [00:48:30] we're actually building the glue that builds out experiences between the multiple systems.

And so those are just some of the people. It's not a comprehensive list of everyone who's been on the show, but those are some of the people I want to thank. We had another great year. This year, quarter of a million downloads. I'd like to tell people we've had close to half a million downloads since the start of the pandemic.

And you know, which includes our YouTube channel which is growing and the social media posts as well. I want to thank you the listeners, [00:49:00] we wouldn't be doing this if you weren't listening. And so I really appreciate you providing the the impetus to move forward and to continue to make investments, to make this a better channel.

And we always appreciate your feedback. Send it to I read them all.

Respond to as many as I can. And so I appreciate that. If you haven't already please go out and subscribe to our four new channels. Starting next year, we will be having four new channels. You can subscribe to that today. Just go to [00:49:30] our homepage or you can go to apple podcasts search for this week health or this week in health IT. You should see our four channels, the conference channel, the news channel, the community channel and the academy. And we would love to have you be a part of our community next year. That's all for today. If you know someone that might benefit, please forward them a note. They can subscribe and all those places I just talked about.

We want to thank our channel sponsors who are investing in our mission to develop the next generation of health IT leaders. [00:50:00] Those are VMware, Hill-Rom, StarBridge Advisers, Aruba and McAfee. Thanks for listening. That's all for now.


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