Revisiting 2021 Predictions – Part 1

Bill Russell 00:00:03 Today in health, it, we are going to revisit my Bill Russell 00:00:06 predictions from earlier in the year, actually from early February. Bill Russell 00:00:10 We had three shows, which we did predictions on. Bill Russell 00:00:12 I'm going to try to condense that down into two shows and Bill Russell 00:00:15 we're going to see how do I do. Bill Russell 00:00:17 Did I get anywhere close. Bill Russell 00:00:19 My name is bill Russell. Bill Russell 00:00:20 I'm a former CIO for a 16 hospital system and creator of this week and Bill Russell 00:00:23 health it a channel dedicated to keeping health it staff current and engaged. Bill Russell 00:00:29 All right. Bill Russell 00:00:30 Let's just jump in. Bill Russell 00:00:31 Here's what I'm going to do. Bill Russell 00:00:32 I'm just going to play these episodes in their entirety, cutting down some of the Bill Russell 00:00:36 parts, just so you can get the gist of it. Bill Russell 00:00:39 And so that we could fit it into two days and just let you decide, Bill Russell 00:00:43 how did I do, let me know how I did bill it this week and health it.com. Bill Russell 00:00:46 Here we go. Bill Russell 00:00:47 Let's just get right to them. Bill Russell 00:00:49 My first one is. Bill Russell 00:00:51 It's really around cloud and cloud adoption. Bill Russell 00:00:53 So, uh, Microsoft is winning the move to the cloud and healthcare. Bill Russell 00:00:56 There's no doubt about that. Bill Russell 00:00:57 This was one of my predictions from last year, COVID threw a serious Bill Russell 00:01:01 wrench into all predictions, but this one held up in spades. Bill Russell 00:01:04 In fact, COVID help Microsoft. Bill Russell 00:01:07 , the reason people go to Microsoft is because it's the incumbent and they make Bill Russell 00:01:11 it easy with their renewal agreement to just check a box and get more software. Bill Russell 00:01:16 You know, in, in, in a crisis, Ms. Bill Russell 00:01:19 Teams became the go-to platform for remote work and collaboration for Bill Russell 00:01:23 just about every health care system. Bill Russell 00:01:25 I'm on, I'm on a lot of team teams meetings these days. Bill Russell 00:01:29 Uh, this isn't the only reason they are winning. Bill Russell 00:01:31 Uh, they also have a, a tool set that, that doesn't require any change to the Bill Russell 00:01:35 existing staff skills when you move to the cloud or, or at least not much of Bill Russell 00:01:39 a change, let's just say it that way. Bill Russell 00:01:41 Uh, you know, data moved to the cloud in 2020 as well. Bill Russell 00:01:45 Um, and that is really my prediction for 2020. Bill Russell 00:01:48 There w there will be the start of a serious move to the cloud for Bill Russell 00:01:51 healthcare, uh, and, and specifically healthcare data, uh, Mayo and Bill Russell 00:01:56 Ascension have tapped into Google. Bill Russell 00:01:57 Cerner's tapped into AWS. Bill Russell 00:01:59 Providence has a massive agreement with Microsoft, uh, and health catalyst, uh, Bill Russell 00:02:04 is built on Microsoft for that matter. Bill Russell 00:02:06 Uh, 20, 21. Bill Russell 00:02:07 We'll see health systems go beyond extending into the cloud for data Bill Russell 00:02:11 platforms, and there will be full on use of the cloud for data tools and cloud Bill Russell 00:02:16 data platforms will be used extensively for non transactional data requirements. Bill Russell 00:02:22 Uh, this will facilitate multicloud data platforms in 2022 and beyond Bill Russell 00:02:26 with a transactional systems really starting to follow. Bill Russell 00:02:30 In 2022 with things like epic in the cloud on top of Irish, Bill Russell 00:02:35 Irish was designed for the cloud. Bill Russell 00:02:37 Uh, but I think you're going to see the, uh, performance enhancements Bill Russell 00:02:41 and other things that come along with the new architecture is Bill Russell 00:02:45 going to allow epic to fully. Bill Russell 00:02:47 Work in the cloud. Bill Russell 00:02:48 So that's a 20, 21 prediction. Bill Russell 00:02:50 I think we're going to see more cloud data, uh, movement from healthcare. Bill Russell 00:02:54 We're going to see a data platform start to emerge. Bill Russell 00:02:58 We're going to see cross data platforms and, uh, interesting agreements Bill Russell 00:03:02 start to form between health systems. Bill Russell 00:03:04 To share their data for the, uh, for the good of all. Bill Russell 00:03:07 So, uh, that's uh, that, that's how the cloud is going to grow in 2021. Bill Russell 00:03:12 Uh, let's look at, uh, prediction, number two, the federal health emergencies going Bill Russell 00:03:15 to continue through the end of this year. Bill Russell 00:03:18 Right. Bill Russell 00:03:19 And why is that important? Bill Russell 00:03:20 And while it's important, because tele-health funding is attached to it. Bill Russell 00:03:24 Right. Bill Russell 00:03:24 So we were all worried during the election, you know, is Trump going to Bill Russell 00:03:27 continue the federal health emergency? Bill Russell 00:03:30 And back then I said, this is the silliest conversation going. Bill Russell 00:03:33 This is at least going to continue through the end of the year. Bill Russell 00:03:35 Okay. Bill Russell 00:03:36 So we got through the end of the year, we're looking at this and we're saying, Bill Russell 00:03:39 where are we at with regard to number of people who have had COVID number of Bill Russell 00:03:42 number of people who have been vaccinated. Bill Russell 00:03:44 And, uh, and then you can just look at it and say, let's make the Bill Russell 00:03:48 prediction of how long the federal health emergency is going to go. Bill Russell 00:03:52 Essentially saying we've got another 11 months of the federal health emergency. Bill Russell 00:03:55 I don't think there's any rush to pull this thing off. Bill Russell 00:03:58 I think we're going to get stagnated some somewhere around July timeframe, Bill Russell 00:04:02 where we have plenty of vaccine, but not enough people lined up and we're Bill Russell 00:04:06 going to sort of stutter through that. Bill Russell 00:04:09 Uh, we're going to be stuck at a, uh, I dunno, let's just. Bill Russell 00:04:12 Uh, 60% rate, which by the way, w will be fantastic, uh, compared to where we Bill Russell 00:04:18 are, we were at, uh, in December and where we're at today, um, the, uh, the Bill Russell 00:04:23 virus will slow down significantly, but with that being said, the Bill Russell 00:04:27 federal health emergency is going to continue through the end of the year. Bill Russell 00:04:30 So the biggest thing that means for health, it is that, uh, you Bill Russell 00:04:33 know, tele-health funding, uh, or telehealth will remain funded Bill Russell 00:04:37 at parody for most of 2021. Bill Russell 00:04:42 And this is a chance for every house with some to really build out their Bill Russell 00:04:45 capability with a viable funding stream. Bill Russell 00:04:48 So if I told you, look, we're going to fund tele-health for the next 11 months. Bill Russell 00:04:52 So, you know, continue to build out that you have a revenue stream for Bill Russell 00:04:56 it, but at the end of 2021, you've got to figure out where the revenue Bill Russell 00:05:00 streams is going to come from. Bill Russell 00:05:01 Uh, that to me would be a huge opportunity. Bill Russell 00:05:04 You're you're essentially you're backstopping my, my, Bill Russell 00:05:07 all my telehealth efforts. Bill Russell 00:05:09 And. Bill Russell 00:05:10 You know, so obviously people are going to ask you too, how Bill Russell 00:05:13 are you going to fund it in 2022? Bill Russell 00:05:14 Uh, you know, it's, it's really the age old, you know, there will be, uh, Bill Russell 00:05:19 there will be lines where CMS comes in and funds they're going to fund, Bill Russell 00:05:22 um, uh, behavioral health is going to be funded at almost full parody. Bill Russell 00:05:28 Uh, states are going to try to jump in. Bill Russell 00:05:30 They just don't have enough money to fund it. Bill Russell 00:05:32 Um, but you know, the question is where CMS going to fund Bill Russell 00:05:36 it, they're going to fund it. Bill Russell 00:05:37 They're there. Bill Russell 00:05:38 They're going to have a trove of information, and they're going to Bill Russell 00:05:41 look at where it has been effective and they're going to fund it. Bill Russell 00:05:44 They're I think they're going to fund it around a remote health, into Bill Russell 00:05:48 a rural and underserved communities I think will remain funded. Bill Russell 00:05:53 So there's going to be a, a, an actual funding source, but you can also. Bill Russell 00:05:57 Look at lowering your costs, improving efficiency and outcomes. Bill Russell 00:06:00 And, uh, there's also that, that aspect of, uh, the patient experience Bill Russell 00:06:05 and improving the patient experience because we've done that we can Bill Russell 00:06:09 actually draw more people into our health system in the long run. Bill Russell 00:06:13 So that's a, a, that's a significant move. Bill Russell 00:06:15 The last prediction is for today is returned to bundles and bundled payments. Bill Russell 00:06:20 And I talk about this on today's news stations. Bill Russell 00:06:23 The, uh, you know, bundled payments was really something we saw during the Obama Bill Russell 00:06:30 administration and essentially took things like knees and hip replacements Bill Russell 00:06:35 and said, look, we're going to look at all of the organizations that deliver. Bill Russell 00:06:41 These kinds of services across a significant geography. Bill Russell 00:06:45 And we're going to see what the cost variation is to deliver the same service. Bill Russell 00:06:50 And so they looked at, let's just say, knee replacement, they've looked at knee Bill Russell 00:06:53 replacements across this large swath. Bill Russell 00:06:55 And they said, oh my gosh, look, I mean, the disparity is huge. Bill Russell 00:06:59 Here's what we're going to do at CMS. Bill Russell 00:07:01 We're going to say. Bill Russell 00:07:02 A bundle for knee replacement starts at diagnosis and ends at when you're Bill Russell 00:07:07 actually walking without a Walker or a cane or that kind of stuff. Bill Russell 00:07:10 So it ends up full recovery and we're going to assign a certain amount to that. Bill Russell 00:07:16 And it's going to be based on, I don't know the mean or the average for a Bill Russell 00:07:19 certain geography for delivering that. Bill Russell 00:07:23 And that was, that was the norm during the bide, during the Obama administration. Bill Russell 00:07:27 And therefore it's not hard to extrapolate. Bill Russell 00:07:29 That will probably be the norm, uh, coming into the Biden administration. Bill Russell 00:07:33 We're going to see a return to bundle payments. Bill Russell 00:07:36 Uh, so, you know, what does that mean for health? Bill Russell 00:07:38 It, well, bundled payments are hard and they're hard for a couple of reasons. Bill Russell 00:07:42 One is, you know, you might be one of the people that's above that mean, or Bill Russell 00:07:45 that average, in which case you're gonna have to look at driving your costs down. Bill Russell 00:07:49 Uh, the second is you have to, you have to orchestrate the care. Bill Russell 00:07:52 And a lot of times that care starts before your health system gets involved and it Bill Russell 00:07:56 ends after your health systems involved. Bill Russell 00:07:58 So it stretches your capabilities. Bill Russell 00:08:00 It stretches your digital capabilities to stretch stretches Bill Russell 00:08:03 your health systems capabilities. Bill Russell 00:08:04 You have to figure out a way to deliver a good, I mean, it's Bill Russell 00:08:09 really not at the diagnosis stage. Bill Russell 00:08:11 That's actually the easy part. Bill Russell 00:08:12 The hard part is, is really after. Bill Russell 00:08:15 It's the rehab. Bill Russell 00:08:16 It's the, it's the rehab facilities. Bill Russell 00:08:18 And, uh, where in a lot of cases, we're not owned by the, by the health system. Bill Russell 00:08:23 In which case you had to manage quality, you had to pass data Bill Russell 00:08:26 along to those facilities and you had to manage the delivery. Bill Russell 00:08:31 Uh, so that you didn't have any complications or those kinds of things. Bill Russell 00:08:35 Cause quite frankly, your payment is fixed. Bill Russell 00:08:38 You're not going to get any more than that payment. Bill Russell 00:08:40 Therefore you had to make sure that you were within or below that payment. Bill Russell 00:08:44 And so technologies play a huge role. Bill Russell 00:08:46 They play a huge role in a couple of ways. Bill Russell 00:08:48 We talked about data and. Bill Russell 00:08:51 Transporting the data across the entire continuum, that's obvious, but Bill Russell 00:08:55 the next one is, is really the, uh, the, the whole recovery mechanism. Bill Russell 00:09:00 I think you're going to see a lot of different tools driving care Bill Russell 00:09:03 out of the home and how are we going to be able to, uh, manage and Bill Russell 00:09:08 orchestrate the entire experience? Bill Russell 00:09:10 So that has multiple touch points with technology to determine Bill Russell 00:09:14 pain, to determine, um, you know, complications, uh, to have people Bill Russell 00:09:19 come back at the right time. Bill Russell 00:09:21 So you'll have, uh, the types of digital tools where you're checking Bill Russell 00:09:25 in with a patient on almost a daily basis, if not every other day. Bill Russell 00:09:29 Uh, digitally so that you can track that patient from beginning to Bill Russell 00:09:33 end to ensure that you are going to get the outcome that you need. Bill Russell 00:09:36 So again, not rocket science, but 2021, you'll see a return Bill Russell 00:09:40 to the two bundled payments. Bill Russell 00:09:41 I don't know what they're going to bundle next. Bill Russell 00:09:42 That would be a good prediction. Bill Russell 00:09:43 I should, I should probably think about that. Bill Russell 00:09:45 Talk to some people, figure out what they're going to bundle Bill Russell 00:09:47 next, but, uh, um, you're going to see follow through on that. Bill Russell 00:09:50 And that is where we're going to go. Bill Russell 00:09:52 So that's the first wave of predictions. Bill Russell 00:09:55 You have a move to the cloud specifically with data platforms and lo and behold, Bill Russell 00:09:59 this year we had true Veta and we had, uh, some other solutions that came Bill Russell 00:10:03 to the market, which were significant for the good of mankind, kind of big Bill Russell 00:10:07 data data platforms, but that's not all we, we saw a lot of stuff happened Bill Russell 00:10:11 with individual health systems making moves to the cloud, uh, with regard Bill Russell 00:10:15 to their data platforms as well. Bill Russell 00:10:17 And I still hold to the prediction that in 2022, you're going to see Bill Russell 00:10:21 a lot of transactional systems. Bill Russell 00:10:23 Moved to the cloud as well, such as EHR platforms, which will be Bill Russell 00:10:28 interesting to watch at least. Bill Russell 00:10:29 We will see that start to happen. Bill Russell 00:10:31 At a, data backup and recovery kind of solution. Bill Russell 00:10:36 , the second prediction was federal health emergency. Bill Russell 00:10:38 We'll go through the end of the year. Bill Russell 00:10:40 , because we will get stuck at somewhere around 60% vaccination rate. Bill Russell 00:10:45 It turns out my state is currently at 60% vaccination rate state of California. Bill Russell 00:10:49 62%. Bill Russell 00:10:51 Vaccination rate. Bill Russell 00:10:52 And so we still have the federal health emergency in place, which Bill Russell 00:10:55 means the tele-health funding. Bill Russell 00:10:57 Is still pretty much intact for health systems. Bill Russell 00:11:02 And the returned to bundle payments. Bill Russell 00:11:05 Uh, it remains to be seen whether we're going to see that really go. Bill Russell 00:11:08 , anywhere, but, , I, I believe that we are going to see return to that. Bill Russell 00:11:12 We're going to see that expand and continue to expand. Bill Russell 00:11:15 , and it didn't happen in 2021 could be because of the pandemic Bill Russell 00:11:18 going on and the transitions. Bill Russell 00:11:20 That happened at the federal government level, but, uh, 20, Bill Russell 00:11:24 22, I think we could see that one. Bill Russell 00:11:26 Come back again. Bill Russell 00:11:28 Uh, that's where I'm at today. Bill Russell 00:11:29 I feel pretty good about those three predictions. Bill Russell 00:11:31 There's about four or five more tuning tomorrow and you'll hear the rest. Bill Russell 00:11:36 And then you can give me a grade. Bill Russell 00:11:37 I'd love to hear it. Bill Russell 00:11:39 That's all for today. Bill Russell 00:11:40 If you know someone that might benefit from our channel, Bill Russell 00:11:42 please forward them a note. Bill Russell 00:11:43 They can subscribe on our website this week, health.com or wherever Bill Russell 00:11:46 you listen to podcasts, apple, Google, overcast, Spotify, Stitcher. Bill Russell 00:11:50 You get the picture. Bill Russell 00:11:51 We are everywhere. Bill Russell 00:11:53 We want to thank our channel sponsors who are investing in our mission to develop Bill Russell 00:11:57 the next generation of health leaders. Bill Russell 00:11:59 VMware Hill-Rom Starburst advisers. Bill Russell 00:12:02 McAfee and Aruba networks. Bill Russell 00:12:04 Thanks for listening.