1 00:00:03,600 --> 00:00:06,560 Speaker 1: On this episode of Newsworld, how many of us think 2 00:00:06,600 --> 00:00:10,360 Speaker 1: that healthcare in the United States is ineffective, inefficient, and 3 00:00:10,800 --> 00:00:16,280 Speaker 1: very expensive. In Nebraska and Iowa, information on housing, transportation, 4 00:00:16,600 --> 00:00:21,640 Speaker 1: and other non clinical needs is being exchanged electronically. Doctors 5 00:00:21,640 --> 00:00:25,000 Speaker 1: and healthcare organizations know the importance of health data in 6 00:00:25,040 --> 00:00:28,200 Speaker 1: treating their patients, but they do not have access to 7 00:00:28,240 --> 00:00:31,280 Speaker 1: all of a patient's health data, such as when the 8 00:00:31,320 --> 00:00:33,680 Speaker 1: patient has to go to the emergency room or if 9 00:00:33,720 --> 00:00:36,480 Speaker 1: the patient sees a different doctor in another part of town. 10 00:00:37,200 --> 00:00:40,640 Speaker 1: Because of this inability to share information, patients have to 11 00:00:40,680 --> 00:00:43,960 Speaker 1: provide their health history every time they see a new doctor, 12 00:00:44,280 --> 00:00:47,880 Speaker 1: and doctors don't have the complete picture of their patient's health. 13 00:00:48,680 --> 00:00:53,120 Speaker 1: In twenty twenty, sinc Health, a health information exchange that 14 00:00:53,280 --> 00:00:57,200 Speaker 1: operates in Nebraska and Iowa, began taking steps to address 15 00:00:57,240 --> 00:01:00,720 Speaker 1: that problem. Here to talk more about this new movement 16 00:01:00,760 --> 00:01:04,960 Speaker 1: toward accessing health data and better patient care, I'm really 17 00:01:05,000 --> 00:01:09,120 Speaker 1: pleased to welcome my guests, doctor Jamie Bland, president and 18 00:01:09,200 --> 00:01:13,240 Speaker 1: CEO of sink Health, and Linda Upmeyer, former Speaker of 19 00:01:13,240 --> 00:01:15,880 Speaker 1: the House of Iowa. She now works with sink Health 20 00:01:16,120 --> 00:01:26,880 Speaker 1: advising on health policy. Jamie and Linda thank you for 21 00:01:27,000 --> 00:01:29,920 Speaker 1: joining me, And I just want to say I've personally 22 00:01:29,959 --> 00:01:32,520 Speaker 1: been working on the issue of healthcare from a public 23 00:01:32,600 --> 00:01:36,560 Speaker 1: policy perspective for forty eight years, and there's such a 24 00:01:36,800 --> 00:01:39,800 Speaker 1: range of issues to solve. It's almost like a David 25 00:01:39,840 --> 00:01:42,760 Speaker 1: and Goliath scenario. So I'm glad you're both here to 26 00:01:42,800 --> 00:01:45,399 Speaker 1: talk about what is working in healthcare in Nebraska and 27 00:01:45,400 --> 00:01:48,559 Speaker 1: Iowa and how the rest of the country can maybe 28 00:01:48,680 --> 00:01:52,280 Speaker 1: learn from the example they're setting. So Jamie, let me 29 00:01:52,280 --> 00:01:54,560 Speaker 1: start with you, if you don't mind. You came to 30 00:01:54,600 --> 00:01:57,720 Speaker 1: this position as CEO of Sink Health with a background 31 00:01:57,760 --> 00:02:01,680 Speaker 1: as a registered nurse. How your career in nursing first 32 00:02:01,680 --> 00:02:04,720 Speaker 1: get started, and as I understand it, you served as 33 00:02:04,800 --> 00:02:07,800 Speaker 1: clinic manager in the United States Army. Tell us about 34 00:02:07,880 --> 00:02:11,680 Speaker 1: your experience. Thanks Nute. So, I started as a registered 35 00:02:11,760 --> 00:02:15,679 Speaker 1: nurse and in that experience learned a lot about care 36 00:02:15,720 --> 00:02:21,520 Speaker 1: coordination and having information available to fully support someone's health journey. 37 00:02:21,600 --> 00:02:24,639 Speaker 1: And when I worked for the Army, the care coordination 38 00:02:24,680 --> 00:02:27,800 Speaker 1: and getting records back and forth became really important to 39 00:02:27,840 --> 00:02:30,880 Speaker 1: the work that I was doing, making sure that when 40 00:02:30,919 --> 00:02:34,920 Speaker 1: we outprocessed somebody, all their records went with them and 41 00:02:34,960 --> 00:02:38,399 Speaker 1: back to the United States. So that really impressed upon 42 00:02:38,480 --> 00:02:42,800 Speaker 1: me the importance of information following the person and is 43 00:02:42,840 --> 00:02:48,359 Speaker 1: really what started my journey to informatics, specialty and advanced 44 00:02:48,360 --> 00:02:53,000 Speaker 1: practice nursing, and then ultimately to public health and public 45 00:02:53,000 --> 00:02:57,040 Speaker 1: health informatics, which is what my doctorate is in. So 46 00:02:57,320 --> 00:03:00,639 Speaker 1: from that journey to where I am today as CEO 47 00:03:00,680 --> 00:03:03,720 Speaker 1: of Saint Health and really understanding how difficult it is 48 00:03:03,760 --> 00:03:09,520 Speaker 1: to connect to data, aggregate data, create a data infrastructure 49 00:03:09,720 --> 00:03:14,040 Speaker 1: for various needs across the health care system, and then 50 00:03:14,080 --> 00:03:17,520 Speaker 1: what we most recently saw with a pandemic response and 51 00:03:17,720 --> 00:03:21,480 Speaker 1: the information that was needed to both respond from an 52 00:03:21,520 --> 00:03:24,280 Speaker 1: economic as well as health perspective. Could you take a 53 00:03:24,320 --> 00:03:27,800 Speaker 1: minute and just explain what was that process of sharing 54 00:03:27,840 --> 00:03:32,280 Speaker 1: information to multiple sources, Like somebody's care journey starts in 55 00:03:32,320 --> 00:03:37,840 Speaker 1: primary care and referring to specialty care and ensuring that 56 00:03:37,880 --> 00:03:41,280 Speaker 1: all of that health history goes with somebody to their 57 00:03:41,280 --> 00:03:45,480 Speaker 1: specialty care visit or is easily accessible when they move 58 00:03:45,560 --> 00:03:48,760 Speaker 1: to a new location. All of that in paper records 59 00:03:48,760 --> 00:03:51,600 Speaker 1: and in our first attempts at electronic health records in 60 00:03:51,600 --> 00:03:55,320 Speaker 1: the early two thousands has been a really arduous journey 61 00:03:55,360 --> 00:03:58,720 Speaker 1: for both clinicians as well as individuals. So getting that 62 00:03:58,800 --> 00:04:05,080 Speaker 1: information and package in digital context is something that we've 63 00:04:05,120 --> 00:04:07,680 Speaker 1: worked on through data standards as well as technology over 64 00:04:07,720 --> 00:04:10,560 Speaker 1: the past twenty years, but that proved to be very 65 00:04:10,560 --> 00:04:14,080 Speaker 1: difficult when we were really starting to understand the importance 66 00:04:14,120 --> 00:04:18,400 Speaker 1: of information following the person and moving away from paper 67 00:04:19,000 --> 00:04:23,680 Speaker 1: and having that comprehensive health record ensure that the specialty 68 00:04:23,720 --> 00:04:26,320 Speaker 1: care provider and then back to primary care that that 69 00:04:26,400 --> 00:04:29,120 Speaker 1: information would follow. And we're just now starting to realize 70 00:04:29,440 --> 00:04:33,960 Speaker 1: that investment electronic health records and the importance of having 71 00:04:34,000 --> 00:04:37,839 Speaker 1: the information available across the ecosystem, whether that be acute care, 72 00:04:38,240 --> 00:04:41,600 Speaker 1: ambulatory care like in a primary care especially care clinic, 73 00:04:42,080 --> 00:04:47,559 Speaker 1: emergency rooms, and in the community where individuals seek health care. Linda, 74 00:04:47,640 --> 00:04:50,960 Speaker 1: you were trained as a cardiology nurse practitioner with a 75 00:04:51,040 --> 00:04:53,880 Speaker 1: Bachelor of Science and Nursing from the University of Iowa 76 00:04:54,000 --> 00:04:57,839 Speaker 1: and a Master of Science and Nursing from Drake University. 77 00:04:58,480 --> 00:05:02,000 Speaker 1: What was your experience like working in cardiology. Well, at 78 00:05:02,000 --> 00:05:04,640 Speaker 1: a word nude, it was very, very busy. The hospital 79 00:05:04,839 --> 00:05:08,080 Speaker 1: that I practiced in was a hub. It was in 80 00:05:08,120 --> 00:05:12,040 Speaker 1: a ninety mile radius. We were really the closest place 81 00:05:12,080 --> 00:05:14,720 Speaker 1: for people to get all kinds of special to care. 82 00:05:15,160 --> 00:05:18,960 Speaker 1: So as you could imagine, people came from distances where 83 00:05:18,960 --> 00:05:22,440 Speaker 1: we had not seen them in the hospital before, and 84 00:05:22,480 --> 00:05:26,960 Speaker 1: they've been often seen by people in many different communities, 85 00:05:27,320 --> 00:05:31,159 Speaker 1: so it became very complex when you were doing the consultations, 86 00:05:31,240 --> 00:05:35,160 Speaker 1: the er visits, the admits, and the discharges for people 87 00:05:35,240 --> 00:05:40,400 Speaker 1: that were often elders, very complex cases, often with chronic 88 00:05:40,480 --> 00:05:44,599 Speaker 1: disease that had been treated in other places, and we're 89 00:05:44,720 --> 00:05:48,480 Speaker 1: accessing those people at some of the most tense anxious 90 00:05:48,560 --> 00:05:52,119 Speaker 1: times in their life, when they're having chest pain or 91 00:05:52,480 --> 00:05:56,599 Speaker 1: maybe hypertensive episodes, and then we asked them to help 92 00:05:56,680 --> 00:05:59,880 Speaker 1: us find all of their health records. And it was 93 00:06:00,080 --> 00:06:03,600 Speaker 1: very chaotic at times. And there's no doubt that if 94 00:06:03,640 --> 00:06:07,440 Speaker 1: we'd had a better system, even as system is sophisticated, 95 00:06:07,480 --> 00:06:10,240 Speaker 1: as Jamie described in the Army, we probably would have 96 00:06:10,520 --> 00:06:13,520 Speaker 1: been able to do things quicker and more efficient. Jamie, 97 00:06:14,080 --> 00:06:17,960 Speaker 1: one of the things is developing is the interprofessional collaborative 98 00:06:17,960 --> 00:06:20,640 Speaker 1: care model, which for those of us who are just 99 00:06:20,720 --> 00:06:24,520 Speaker 1: normal patients we need to help with. Could you explain 100 00:06:24,600 --> 00:06:27,640 Speaker 1: to us what the inter professional collaborative care model is 101 00:06:27,680 --> 00:06:32,440 Speaker 1: in healthcare. Yes, it is an interdisciplinary team that is 102 00:06:32,480 --> 00:06:36,120 Speaker 1: responsible for the care and outcomes of individual patients, so 103 00:06:36,720 --> 00:06:41,800 Speaker 1: that results in huddles in the morning talking about progress 104 00:06:41,839 --> 00:06:47,400 Speaker 1: on different aspects of clinical outcomes. So you might think 105 00:06:47,440 --> 00:06:52,480 Speaker 1: of a person with diabetes and the team looking retrospectively 106 00:06:52,520 --> 00:06:59,240 Speaker 1: at blood gukos and every discipline from physician, nurse, social worker, 107 00:07:00,040 --> 00:07:04,120 Speaker 1: the receptionist having these conversations about how the team can 108 00:07:04,200 --> 00:07:08,720 Speaker 1: support an individual in managing their blood glucose levels and 109 00:07:08,960 --> 00:07:13,640 Speaker 1: ensuring that the nutrition information is available and really taking 110 00:07:13,640 --> 00:07:17,040 Speaker 1: a whole person approach to the care outcomes. And the 111 00:07:17,080 --> 00:07:22,400 Speaker 1: more that we move towards care outcomes versus episodic visits 112 00:07:22,440 --> 00:07:25,720 Speaker 1: to a doctor, the better outcomes individuals seem to have. 113 00:07:26,360 --> 00:07:31,320 Speaker 1: Because I understand it, The Institute for Healthcare Improvement came 114 00:07:31,400 --> 00:07:34,480 Speaker 1: up with three key areas to improve delivery of care. 115 00:07:34,720 --> 00:07:40,280 Speaker 1: Can you describe those? The IHI triple aim focuses on population, health, 116 00:07:40,480 --> 00:07:43,320 Speaker 1: experience of care, and per capita costs. So if we're 117 00:07:43,320 --> 00:07:47,000 Speaker 1: looking at an individual with diabetes, again to use that example, 118 00:07:47,520 --> 00:07:50,640 Speaker 1: we're looking at what is the outcome? Is there a 119 00:07:50,680 --> 00:07:55,440 Speaker 1: long term trend in the management instability of blood glucose levels? 120 00:07:56,160 --> 00:07:59,360 Speaker 1: Is their weight loss? Is there things that are improving 121 00:07:59,440 --> 00:08:03,880 Speaker 1: their quality of life. And with that, what is the 122 00:08:03,920 --> 00:08:06,760 Speaker 1: lowest level of intervention that can be applied to those 123 00:08:06,840 --> 00:08:10,680 Speaker 1: better outcomes to control cost And then what is the 124 00:08:10,720 --> 00:08:15,640 Speaker 1: overall population health of the community in which an individual lives. 125 00:08:16,480 --> 00:08:21,760 Speaker 1: How does bringing all this information together affect the experience 126 00:08:21,800 --> 00:08:24,800 Speaker 1: of care by the patient. At one point in my career, 127 00:08:24,800 --> 00:08:28,080 Speaker 1: I worked for the VA, and I remember when we 128 00:08:28,080 --> 00:08:30,560 Speaker 1: were first rolling out some of the population health data 129 00:08:30,560 --> 00:08:34,640 Speaker 1: efforts and providers that were just really certain that they 130 00:08:34,640 --> 00:08:39,360 Speaker 1: were really consistent with their patient interventions, and when we 131 00:08:39,440 --> 00:08:43,640 Speaker 1: provided the data, they could then see where sometimes they 132 00:08:43,640 --> 00:08:47,080 Speaker 1: didn't apply that intervention and what the outcome was. So 133 00:08:47,400 --> 00:08:51,040 Speaker 1: having the information available for providers in a lotitude in 134 00:08:51,040 --> 00:08:53,280 Speaker 1: the health record so they can see what is the 135 00:08:54,040 --> 00:08:57,319 Speaker 1: long term outcomes of an individual patient and then agger 136 00:08:57,360 --> 00:09:00,720 Speaker 1: getting that information over time is where we can start 137 00:09:00,760 --> 00:09:04,800 Speaker 1: to see improvements in outcomes and also working to the 138 00:09:04,840 --> 00:09:09,480 Speaker 1: lowest level of intervention which reduces costs. So if we 139 00:09:09,559 --> 00:09:14,840 Speaker 1: can say, for these five diabetes patients that consult with 140 00:09:14,960 --> 00:09:21,439 Speaker 1: nutrition really helped them manage their long term outcomes, or 141 00:09:21,880 --> 00:09:24,960 Speaker 1: this other group of patients needed to have a different 142 00:09:24,960 --> 00:09:28,840 Speaker 1: medication change, and we monitored that over time, there's a 143 00:09:28,920 --> 00:09:31,720 Speaker 1: cost difference in those two different interventions, and that's what 144 00:09:31,800 --> 00:09:35,080 Speaker 1: the population health interventions are looking at. So are you 145 00:09:35,160 --> 00:09:39,280 Speaker 1: looking to provide sort of a cost effective care that's 146 00:09:39,440 --> 00:09:43,000 Speaker 1: both efficient and keeps you healthy. You're not swapping money 147 00:09:43,040 --> 00:09:46,040 Speaker 1: for health, but you're trying to achieve both. We're trying 148 00:09:46,080 --> 00:09:51,040 Speaker 1: to achieve the most effective outcomes for the lowest cost possible. 149 00:09:51,520 --> 00:09:54,360 Speaker 1: And you know, in an era of high deductible healthcare plans, 150 00:09:54,400 --> 00:09:58,600 Speaker 1: that means real money to individual people. And we want 151 00:09:58,640 --> 00:10:02,679 Speaker 1: to ensure that if we can provide the data that 152 00:10:02,800 --> 00:10:06,559 Speaker 1: providers can make those population health level decisions as well 153 00:10:06,600 --> 00:10:10,880 Speaker 1: as have individual personal level information available. That's where we 154 00:10:10,960 --> 00:10:15,880 Speaker 1: want to ensure that whoever is treating the patient has 155 00:10:15,920 --> 00:10:20,160 Speaker 1: the most comprehensive information possible, not just what's contained in 156 00:10:20,200 --> 00:10:23,319 Speaker 1: their electronic health record, what the information is along the 157 00:10:23,400 --> 00:10:27,720 Speaker 1: lontitudinal health journey. I really got interested in SINC health 158 00:10:28,360 --> 00:10:31,319 Speaker 1: because way back in two thousand and three, I wrote 159 00:10:31,320 --> 00:10:34,800 Speaker 1: a book called Saving Lives and Saving Money, and I 160 00:10:34,880 --> 00:10:36,559 Speaker 1: made the point that it was in that order that 161 00:10:36,960 --> 00:10:41,800 Speaker 1: health is a moral requirement, not just a market oriented requirement, 162 00:10:42,040 --> 00:10:44,440 Speaker 1: and so you have to first focus on saving lives 163 00:10:44,480 --> 00:10:48,600 Speaker 1: and then within the framework of saving lives, you focus 164 00:10:48,679 --> 00:10:51,040 Speaker 1: on saving money. And it seems to me that a 165 00:10:51,040 --> 00:10:54,200 Speaker 1: lot of what sink Health has done is improve our 166 00:10:54,240 --> 00:10:57,199 Speaker 1: ability to both save your life and to do so 167 00:10:57,400 --> 00:11:00,960 Speaker 1: in a cost effective manner. Absolutely, so if you look 168 00:11:01,000 --> 00:11:05,160 Speaker 1: at some of the policy efforts that individuals like Linda 169 00:11:05,240 --> 00:11:09,040 Speaker 1: have helped us to achieve. Both in Nebraska and Iowa, 170 00:11:09,480 --> 00:11:14,800 Speaker 1: we have comprehensive medication history available to all providers in Nebraska. 171 00:11:14,880 --> 00:11:17,640 Speaker 1: That was a concerted effort by the legislature to do that, 172 00:11:17,720 --> 00:11:20,880 Speaker 1: and that's a patient safety tool. So if we look 173 00:11:20,920 --> 00:11:25,679 Speaker 1: at the complexity of prescriptions that are prescribed to an 174 00:11:25,679 --> 00:11:29,000 Speaker 1: individual and having that information available to each provider so 175 00:11:29,080 --> 00:11:33,280 Speaker 1: there's not duplication and kinds of medication, so that there's 176 00:11:33,320 --> 00:11:38,559 Speaker 1: not an adverse reaction or a potential allergic reaction having 177 00:11:38,600 --> 00:11:41,840 Speaker 1: that information available. Nebraska is the only state in the 178 00:11:41,880 --> 00:11:45,360 Speaker 1: country that has had that policy effort to ensure that 179 00:11:45,360 --> 00:11:49,079 Speaker 1: that kind of information is available to all providers. So 180 00:11:49,280 --> 00:11:53,320 Speaker 1: we know that polypharmacy is a problem, and that's the 181 00:11:53,360 --> 00:11:58,160 Speaker 1: way that Nebraska decided to address that. Similarly, the comprehensiveness 182 00:11:58,200 --> 00:12:02,640 Speaker 1: of the acute care so all the hospitals Connected is 183 00:12:02,679 --> 00:12:05,880 Speaker 1: an effort that we've worked on in Nebraska for the 184 00:12:05,960 --> 00:12:10,559 Speaker 1: past decade, and Iowa's taken a giant leap forward underneath 185 00:12:10,640 --> 00:12:14,679 Speaker 1: Governor Renal leadership to make that a reality in Iowa 186 00:12:14,720 --> 00:12:18,600 Speaker 1: as well. So we're very excited about the comprehensiveness of 187 00:12:18,679 --> 00:12:21,640 Speaker 1: information that will be available to Iowa providers as well 188 00:12:21,679 --> 00:12:24,160 Speaker 1: as your first woman to be Speaker of the House. 189 00:12:24,760 --> 00:12:27,760 Speaker 1: From your standpoint is you've watched the system which initially 190 00:12:27,760 --> 00:12:31,840 Speaker 1: evolved in Nebraska but is now mature dramatically. What is 191 00:12:31,840 --> 00:12:34,800 Speaker 1: the impact as you watch it moving into Iowa and 192 00:12:34,880 --> 00:12:39,360 Speaker 1: what impact is it having on both patients and delivery systems. Absolutely, 193 00:12:39,520 --> 00:12:42,520 Speaker 1: when we first started talking about how we would share 194 00:12:42,559 --> 00:12:47,040 Speaker 1: information twenty years ago, we were talking about doing it 195 00:12:47,240 --> 00:12:50,280 Speaker 1: in paper and how we could be effective. And now 196 00:12:50,320 --> 00:12:53,840 Speaker 1: here we are. Technology has made it possible and we 197 00:12:53,920 --> 00:12:59,480 Speaker 1: have the applications available to actually truly make this enter 198 00:13:00,080 --> 00:13:03,520 Speaker 1: verbal system. And the only thing that stands in our 199 00:13:03,559 --> 00:13:07,880 Speaker 1: way now, in my mind, is people's reluxance to share 200 00:13:08,679 --> 00:13:13,240 Speaker 1: and focus on the mission putting the patient at the center. Well, 201 00:13:13,320 --> 00:13:15,240 Speaker 1: Y ask both of you, what do you think can 202 00:13:15,280 --> 00:13:19,240 Speaker 1: be done to encourage big healthcare systems, whether they're private 203 00:13:19,360 --> 00:13:22,640 Speaker 1: or government like Medicare and Medicaid to follow this kind 204 00:13:22,679 --> 00:13:25,640 Speaker 1: of a model. So I really think it starts with 205 00:13:25,760 --> 00:13:29,880 Speaker 1: those that want to see real improvement in cost and quality, 206 00:13:30,440 --> 00:13:33,959 Speaker 1: and that's really where it started in Nebraska and Iowa 207 00:13:34,160 --> 00:13:39,319 Speaker 1: organically with healthcare systems and then moved to involving government 208 00:13:39,360 --> 00:13:42,760 Speaker 1: and public health and Medicaid and Medicare to be a 209 00:13:42,800 --> 00:13:46,840 Speaker 1: part of the system. And I think what the results 210 00:13:46,840 --> 00:13:52,199 Speaker 1: show is that's better care coordination, better outcomes, more insights 211 00:13:52,240 --> 00:13:54,520 Speaker 1: into the work that needs to be done for our 212 00:13:54,600 --> 00:13:58,440 Speaker 1: population health and where there needs to be more concerted 213 00:13:58,480 --> 00:14:02,640 Speaker 1: focus and being more data driven in where healthcare is delivered, 214 00:14:02,960 --> 00:14:05,920 Speaker 1: whether that be in a hospital or in the community, 215 00:14:06,040 --> 00:14:09,720 Speaker 1: or in a social care setting like a church or 216 00:14:09,760 --> 00:14:13,880 Speaker 1: a community center. Those are all very different approaches to 217 00:14:13,960 --> 00:14:18,080 Speaker 1: healthcare delivery and rethinking how individuals want to interact with 218 00:14:18,120 --> 00:14:21,160 Speaker 1: the healthcare system. So I think if that's where the 219 00:14:21,240 --> 00:14:25,240 Speaker 1: strategy is going, the technology and data are evolved to 220 00:14:25,240 --> 00:14:28,360 Speaker 1: the point where these systems can be implemented. So I 221 00:14:28,400 --> 00:14:31,440 Speaker 1: think that's where some of the challenges historically have been 222 00:14:31,920 --> 00:14:34,200 Speaker 1: the technology needed to catch up, and then the data 223 00:14:34,240 --> 00:14:36,800 Speaker 1: standards needed to catch up. And I think we're in 224 00:14:36,840 --> 00:14:39,680 Speaker 1: a really good place now, and I think that from 225 00:14:39,720 --> 00:14:43,600 Speaker 1: a statewide perspective, more and more part of the conversation 226 00:14:43,800 --> 00:15:05,880 Speaker 1: of what's next for both healthcare delivery and public health Jamie, 227 00:15:05,920 --> 00:15:08,120 Speaker 1: you know, one of the big problems has been that 228 00:15:08,280 --> 00:15:11,800 Speaker 1: health data is typically owned by one provider instead of 229 00:15:11,800 --> 00:15:15,760 Speaker 1: being shared through multiple providers to sort of follow the patient. 230 00:15:16,320 --> 00:15:19,520 Speaker 1: How do you deal with them? A lot of education 231 00:15:19,600 --> 00:15:24,840 Speaker 1: about individual people having access to their data and the 232 00:15:24,960 --> 00:15:30,560 Speaker 1: governance and oversight of the data following the individual. So 233 00:15:31,080 --> 00:15:35,280 Speaker 1: in recent policy considerations the twenty first century kers and 234 00:15:35,440 --> 00:15:38,760 Speaker 1: people having access rights to their information. That's clarified some 235 00:15:38,840 --> 00:15:43,440 Speaker 1: of that conversation, but we certainly still encounter some resistance 236 00:15:43,560 --> 00:15:46,240 Speaker 1: in the sharing of information. And I think if we 237 00:15:46,280 --> 00:15:49,520 Speaker 1: approach a system like this as a utility right that 238 00:15:50,080 --> 00:15:53,240 Speaker 1: people have access to their information, providers have access to 239 00:15:53,280 --> 00:15:58,000 Speaker 1: the information, payers have more limited access to the information 240 00:15:58,040 --> 00:16:04,600 Speaker 1: for payment purposes, but really understanding the access points, putting 241 00:16:04,640 --> 00:16:08,560 Speaker 1: insecurity and governance layers around that, and then ensuring that 242 00:16:08,760 --> 00:16:11,720 Speaker 1: people have the priority in the access to the information, 243 00:16:12,320 --> 00:16:15,920 Speaker 1: and then providers having access for the purposes of treatment 244 00:16:16,360 --> 00:16:20,400 Speaker 1: and operations so that they are able to access in 245 00:16:20,560 --> 00:16:22,880 Speaker 1: near real time the information that they need to make 246 00:16:22,920 --> 00:16:28,000 Speaker 1: better clinical decisions. So when you have this capability across 247 00:16:28,040 --> 00:16:31,480 Speaker 1: the entire care team to talk with each other and 248 00:16:31,560 --> 00:16:34,560 Speaker 1: to see what's going on. And from that standpoint, does 249 00:16:35,160 --> 00:16:38,800 Speaker 1: this kind of data access across the whole system provide 250 00:16:38,800 --> 00:16:43,280 Speaker 1: a kind of transparency for patient care? Oh? Absolutely, not 251 00:16:43,360 --> 00:16:48,240 Speaker 1: only transparency, but continuity and safety for individual patient outcomes. 252 00:16:48,320 --> 00:16:51,280 Speaker 1: The more information that is available for a provider to 253 00:16:51,360 --> 00:16:54,960 Speaker 1: make a comprehensive clinical decision, the better I know as 254 00:16:54,960 --> 00:16:57,640 Speaker 1: a nurse. The more that we can have information about 255 00:16:57,760 --> 00:17:03,520 Speaker 1: pharmacy history, allergies to medications, and just different reactions to 256 00:17:03,600 --> 00:17:07,720 Speaker 1: medications or different outcomes that from different encounters, we make 257 00:17:07,760 --> 00:17:12,080 Speaker 1: better decisions going forward. This information flow, how does that 258 00:17:12,240 --> 00:17:15,879 Speaker 1: fit in with hip of the Health Insurance Portability and 259 00:17:15,880 --> 00:17:21,120 Speaker 1: Accountability Act, which was designed to safeguard information but sometimes 260 00:17:21,119 --> 00:17:24,800 Speaker 1: gets a little bit bureaucratic in its application, right, So 261 00:17:24,840 --> 00:17:28,760 Speaker 1: an organization like sync health provides that governance layer so 262 00:17:28,800 --> 00:17:33,080 Speaker 1: that we're looking at individual access. So providers have treatment purposes, 263 00:17:33,640 --> 00:17:37,360 Speaker 1: your health insurance company has payment purposes, and then there 264 00:17:37,440 --> 00:17:41,000 Speaker 1: might be some operational instances that need to have access 265 00:17:41,000 --> 00:17:44,520 Speaker 1: to that information. So if you think about quality reporting 266 00:17:44,960 --> 00:17:49,080 Speaker 1: to CMS as an example, or to report publicly on quality. 267 00:17:49,480 --> 00:17:52,400 Speaker 1: Those are some operational purposes that data can be used for. 268 00:17:52,880 --> 00:17:55,600 Speaker 1: But systems like these, individual patients, if they don't want 269 00:17:55,600 --> 00:17:58,120 Speaker 1: their data shared, can opt out of them. So that's 270 00:17:58,200 --> 00:18:01,960 Speaker 1: the benefit of having a governance framework around the sharing 271 00:18:02,000 --> 00:18:05,719 Speaker 1: of information versus just point to point sharing of information, 272 00:18:05,760 --> 00:18:08,600 Speaker 1: which is a little more limited in where people have 273 00:18:08,640 --> 00:18:11,280 Speaker 1: a voice in how their data is shared. I'm going 274 00:18:11,320 --> 00:18:13,960 Speaker 1: to go back to that utility type of context that 275 00:18:14,040 --> 00:18:17,720 Speaker 1: it's available and you can certainly opt out of the 276 00:18:17,760 --> 00:18:22,840 Speaker 1: sharing of information. But in times of emergent use cases 277 00:18:23,000 --> 00:18:26,960 Speaker 1: or chronic care needs, or you get to an age 278 00:18:26,960 --> 00:18:28,840 Speaker 1: where you know what, I just really want all my 279 00:18:28,920 --> 00:18:32,760 Speaker 1: doctors to have all my information, then those governance frameworks 280 00:18:32,840 --> 00:18:37,720 Speaker 1: come in handy to ensure that that's readily easily accessible information. 281 00:18:38,280 --> 00:18:41,639 Speaker 1: So as I understand, sometimes when you can scan electronically 282 00:18:42,200 --> 00:18:45,679 Speaker 1: a large enough database. I think it was Kaiser Permanente 283 00:18:46,000 --> 00:18:49,280 Speaker 1: that found that the vox had a problem that only 284 00:18:49,320 --> 00:18:51,520 Speaker 1: showed up if you've had access to lots and lots 285 00:18:51,560 --> 00:18:55,200 Speaker 1: of data. Do you know some examples where data trends 286 00:18:55,200 --> 00:19:00,399 Speaker 1: and population suddenly surfaced a problem opioid crisis, for certain 287 00:19:00,600 --> 00:19:03,560 Speaker 1: the amount of medications that were being prescribed, who is 288 00:19:03,600 --> 00:19:07,560 Speaker 1: prescribing them. I think those are all certainly things that 289 00:19:07,760 --> 00:19:11,919 Speaker 1: come into play. And then anytime there's emergency room visits 290 00:19:12,000 --> 00:19:16,720 Speaker 1: and those medications are found to be a consistent across 291 00:19:16,800 --> 00:19:22,160 Speaker 1: the patient population. Absolutely. I think if you look at semaglutides, 292 00:19:22,200 --> 00:19:25,679 Speaker 1: a diabetes medication, and one of the things that was 293 00:19:25,760 --> 00:19:30,399 Speaker 1: found was that individuals on that type of diabetes medication, 294 00:19:30,840 --> 00:19:34,520 Speaker 1: we're also losing weight and we're also having good results 295 00:19:34,520 --> 00:19:37,520 Speaker 1: in portion control. Those are also some positive things that 296 00:19:37,560 --> 00:19:41,120 Speaker 1: we can find in different medication responses as well, as 297 00:19:41,160 --> 00:19:45,480 Speaker 1: I understand it, some studies indicate that up to eighty 298 00:19:45,520 --> 00:19:48,440 Speaker 1: percent of a person's health outcomes come from what are 299 00:19:48,440 --> 00:19:52,000 Speaker 1: called social determinants. So, for those of us who aren't 300 00:19:52,440 --> 00:19:55,880 Speaker 1: thoroughly understanding this field, what is a concept of social 301 00:19:55,920 --> 00:20:00,160 Speaker 1: determinants of health and how does it impact people? Yeah, 302 00:20:00,160 --> 00:20:03,760 Speaker 1: so we can look at food insecurity as one aspect 303 00:20:03,840 --> 00:20:07,440 Speaker 1: of a social determinant. And I'm going to go back 304 00:20:07,480 --> 00:20:12,080 Speaker 1: to the diabetes example. So if we're having nutrition consult 305 00:20:12,240 --> 00:20:17,119 Speaker 1: and acceptance of changing a diet to be more fresh 306 00:20:17,119 --> 00:20:20,120 Speaker 1: fruits and vegetables, and then we see and follow up 307 00:20:20,160 --> 00:20:22,840 Speaker 1: that that didn't have an impact or they weren't able 308 00:20:22,880 --> 00:20:26,280 Speaker 1: to stick to the diet regiment. And then we find 309 00:20:26,280 --> 00:20:29,000 Speaker 1: out that somebody doesn't have a refrigerator in the home 310 00:20:29,440 --> 00:20:32,280 Speaker 1: to be able to store fresh fruits and vegetables. That's 311 00:20:32,320 --> 00:20:35,600 Speaker 1: certainly a social determinant in the ability to manage a 312 00:20:35,600 --> 00:20:40,280 Speaker 1: diabetic diet, right. So I think that's one instance where 313 00:20:40,640 --> 00:20:44,840 Speaker 1: understanding the social aspects, what is the home life of somebody, 314 00:20:45,080 --> 00:20:49,160 Speaker 1: Can they actually get to the doctor's appointments through consistent 315 00:20:49,720 --> 00:20:54,280 Speaker 1: transportation or do they need referrals to community based resources 316 00:20:54,280 --> 00:20:57,600 Speaker 1: so that we can appropriately manage diabetes so that they 317 00:20:57,640 --> 00:21:01,120 Speaker 1: don't show up in the emergency room with a very 318 00:21:01,119 --> 00:21:04,360 Speaker 1: expensive visit for a diabetes keto acidosis as an example. 319 00:21:04,800 --> 00:21:08,120 Speaker 1: So there's definitely lower cost interventions that we can put 320 00:21:08,160 --> 00:21:12,360 Speaker 1: in place, whether that be finding a refrigerator, ensuring that 321 00:21:12,400 --> 00:21:16,200 Speaker 1: the electricity stays on, in that the housing is reliable 322 00:21:16,200 --> 00:21:18,919 Speaker 1: and consistent. So, in a sense, you sometimes have to 323 00:21:18,920 --> 00:21:22,920 Speaker 1: treat the entire person in their environment, their neighborhood, etc. 324 00:21:23,760 --> 00:21:26,119 Speaker 1: In order to get at the specific disease or the 325 00:21:26,200 --> 00:21:32,160 Speaker 1: specific problem. Yeah, absolutely, there's definitely trends We can look 326 00:21:32,200 --> 00:21:35,560 Speaker 1: at different zip codes that have higher incidents of diabetes. 327 00:21:35,600 --> 00:21:39,760 Speaker 1: What is the availability of grocery stores in those zip codes? 328 00:21:40,160 --> 00:21:44,879 Speaker 1: What is the transportation schedule for public transportation. All of 329 00:21:44,920 --> 00:21:47,640 Speaker 1: those things can factor into can you get to your 330 00:21:47,680 --> 00:21:50,600 Speaker 1: doctor's visits, can you get to the grocery store, can 331 00:21:50,640 --> 00:21:53,120 Speaker 1: you manage your chronic disease, and what are the long 332 00:21:53,200 --> 00:21:57,080 Speaker 1: term outcomes and ultimately what is the cost of treatment 333 00:21:57,160 --> 00:22:00,560 Speaker 1: for those individuals. One of the things it came out 334 00:22:00,600 --> 00:22:03,320 Speaker 1: of all this with the opioid epidemic, which has been 335 00:22:03,359 --> 00:22:06,680 Speaker 1: truly tragic, but it's led to a real breakthrough. It's 336 00:22:06,720 --> 00:22:11,840 Speaker 1: endom and the medication reconciliation tool you use in Nebraska, 337 00:22:12,080 --> 00:22:14,400 Speaker 1: can you explain what drove that and how does this 338 00:22:15,040 --> 00:22:20,639 Speaker 1: medication reconciliation tool work. The medication reconciliation tool originated so 339 00:22:20,680 --> 00:22:23,479 Speaker 1: the pharmacies could track if one person was getting multiple 340 00:22:23,520 --> 00:22:28,480 Speaker 1: prescriptions for opioids filled up multiple locations. Typically, those pharmacies 341 00:22:28,480 --> 00:22:30,960 Speaker 1: were not linked and would not talk to each other, 342 00:22:31,400 --> 00:22:33,840 Speaker 1: so to speak, unless they were owned by the same 343 00:22:33,880 --> 00:22:38,720 Speaker 1: corporation with the same computer system. Now, now, thanks to 344 00:22:38,800 --> 00:22:43,080 Speaker 1: Nebraska Legislative Bill four seventy one, signed into law by 345 00:22:43,119 --> 00:22:47,359 Speaker 1: the governor in twenty sixteen. All of our pharmacies in 346 00:22:47,440 --> 00:22:50,960 Speaker 1: Nebraska are linked. They do talk to each other. It 347 00:22:51,040 --> 00:22:54,639 Speaker 1: would just add that the providers have confidence in a 348 00:22:54,640 --> 00:23:01,560 Speaker 1: tool that's comprehensive, and that medication reconciliation effort is something 349 00:23:01,640 --> 00:23:05,399 Speaker 1: that's definitely contributing to cost and quality outcomes. If you 350 00:23:05,600 --> 00:23:09,160 Speaker 1: look at Nebraska and Iowa where they're at, and opioid 351 00:23:09,200 --> 00:23:13,199 Speaker 1: dusts across the country, we definitely have robust utilization and 352 00:23:13,280 --> 00:23:16,400 Speaker 1: confidence in the tool, both the data and the functionality 353 00:23:16,680 --> 00:23:19,280 Speaker 1: of the technology. You know, I mean, it would seem 354 00:23:19,320 --> 00:23:21,879 Speaker 1: to me that virtually every state should adopt something like 355 00:23:21,920 --> 00:23:26,280 Speaker 1: this because we have such a continuing opioid problem around 356 00:23:26,320 --> 00:23:29,720 Speaker 1: the whole country. That would just be hugely advantageous. It 357 00:23:29,840 --> 00:23:33,680 Speaker 1: also seems to me that Medicare and Medicaid systems could 358 00:23:33,720 --> 00:23:37,440 Speaker 1: benefit by using data like this to manage their patient care. 359 00:23:38,400 --> 00:23:40,680 Speaker 1: In part, there's so much waste in these two programs 360 00:23:40,720 --> 00:23:44,439 Speaker 1: because it's run by bureaucracies. Can you describe when you 361 00:23:44,440 --> 00:23:47,560 Speaker 1: go first to doctor Blenn, then to Linda Upmyer, but 362 00:23:47,640 --> 00:23:50,399 Speaker 1: doctor Blen, could you describe a little bit about the 363 00:23:50,400 --> 00:23:54,520 Speaker 1: potential of connecting all the health data for something like 364 00:23:54,600 --> 00:23:58,440 Speaker 1: Medicaid or Medicare, and the impact it can have an 365 00:23:58,480 --> 00:24:03,000 Speaker 1: improving outcome for the poor will also saving the taxpayer 366 00:24:03,080 --> 00:24:07,640 Speaker 1: money absolutely. So a lot of the health information exchanges 367 00:24:07,680 --> 00:24:12,160 Speaker 1: across the country started out of Medicaid initiatives underneath the 368 00:24:12,240 --> 00:24:15,280 Speaker 1: High Tech Act, which I think you are very familiar 369 00:24:15,320 --> 00:24:19,560 Speaker 1: with when that came into the political conversation, But a 370 00:24:19,600 --> 00:24:23,840 Speaker 1: lot of investment across the country went into more regional systems, 371 00:24:23,840 --> 00:24:28,399 Speaker 1: and I think the statewide systems is definitely where a 372 00:24:28,440 --> 00:24:31,919 Speaker 1: lot of the value comes because of this patient movement 373 00:24:31,960 --> 00:24:35,800 Speaker 1: across healthcare systems as well as across communities, and that 374 00:24:35,880 --> 00:24:42,240 Speaker 1: connectedness as an initiative from Medicare Medicaid is definitely incented, 375 00:24:42,320 --> 00:24:45,399 Speaker 1: but there does need to be policy effort around the 376 00:24:45,840 --> 00:24:50,960 Speaker 1: compelling for providers to share information and to Linda's point earlier, 377 00:24:51,000 --> 00:24:54,920 Speaker 1: around really for the patient benefits. So the patient has 378 00:24:54,960 --> 00:24:57,000 Speaker 1: a lot of studental health record, so they don't have 379 00:24:57,600 --> 00:25:00,639 Speaker 1: six seven eight portals to go and get information and 380 00:25:00,680 --> 00:25:03,600 Speaker 1: then print it off and carry that to their providers, 381 00:25:03,640 --> 00:25:07,760 Speaker 1: which is where states that don't have health information exchange 382 00:25:08,119 --> 00:25:10,840 Speaker 1: that's how it happens today. So I think there's a 383 00:25:10,840 --> 00:25:13,840 Speaker 1: lot of effort around what does it look like for 384 00:25:14,280 --> 00:25:16,720 Speaker 1: a state to have more of a utility type of 385 00:25:16,760 --> 00:25:21,600 Speaker 1: approach to healthcare data infrastructure, so that we can start 386 00:25:21,640 --> 00:25:24,719 Speaker 1: to look at broad quality, not just siloed in a 387 00:25:24,720 --> 00:25:28,040 Speaker 1: healthcare system or not by one community, broadly what it 388 00:25:28,040 --> 00:25:31,000 Speaker 1: looks like across a state, and then we can break 389 00:25:31,000 --> 00:25:35,080 Speaker 1: it into regions and different communities. But that's the baseline 390 00:25:35,080 --> 00:25:38,439 Speaker 1: of infrastructure that's needed to really look at cost and 391 00:25:38,520 --> 00:25:43,399 Speaker 1: quality on a consistent basis with adopted data definitions and 392 00:25:43,480 --> 00:25:46,360 Speaker 1: data standards to ensure the highest quality of data possible. 393 00:26:03,800 --> 00:26:06,439 Speaker 1: You've been doing amazing things at sink Health. Could you 394 00:26:06,520 --> 00:26:10,400 Speaker 1: describe how sink Health sees its mission and the way 395 00:26:10,400 --> 00:26:15,000 Speaker 1: it sees developing its relationship with the health system over 396 00:26:15,000 --> 00:26:18,200 Speaker 1: the next few years. Yeah. I see sink health mission 397 00:26:18,320 --> 00:26:24,360 Speaker 1: as providing longitudinal healthcare records to all citizens and communities 398 00:26:24,359 --> 00:26:29,680 Speaker 1: that we serve and supporting both what providers need for care, 399 00:26:29,800 --> 00:26:34,480 Speaker 1: what people need to manage their care, and also what 400 00:26:34,640 --> 00:26:38,240 Speaker 1: public health and governors need to manage the population health 401 00:26:38,240 --> 00:26:42,399 Speaker 1: of their states. So really focusing in on the different 402 00:26:42,480 --> 00:26:46,679 Speaker 1: use cases for data, the different use cases that providers 403 00:26:46,760 --> 00:26:51,359 Speaker 1: need information for, and then easy access to individual people, 404 00:26:51,840 --> 00:26:54,960 Speaker 1: so that the burden of technology is not borne by 405 00:26:55,000 --> 00:26:58,960 Speaker 1: individuals in the community. Let me ask you for a second, Linda, 406 00:26:59,520 --> 00:27:03,080 Speaker 1: you see this both as a nurse, you've seen it 407 00:27:03,119 --> 00:27:05,840 Speaker 1: as an elected official. How big a difference do you 408 00:27:05,840 --> 00:27:10,159 Speaker 1: think it makes if patient care is surrounded by the 409 00:27:10,280 --> 00:27:14,920 Speaker 1: kind of information flow the sink Health is developing. At 410 00:27:14,960 --> 00:27:19,040 Speaker 1: the heart of this matter is putting patients first. And 411 00:27:19,119 --> 00:27:22,600 Speaker 1: so as all of the systems, the big systems, the 412 00:27:22,680 --> 00:27:27,359 Speaker 1: small systems, all of us wrap our arms around this 413 00:27:27,520 --> 00:27:31,960 Speaker 1: technology and really figure out how we're going to use it. 414 00:27:32,000 --> 00:27:36,439 Speaker 1: If we always keep the patients, the citizens, the people 415 00:27:36,960 --> 00:27:40,439 Speaker 1: that we're caring for at the center of this, I 416 00:27:40,480 --> 00:27:44,000 Speaker 1: think everybody can get where we need to be to 417 00:27:44,000 --> 00:27:48,560 Speaker 1: really accomplish this successfully. But too often people get distracted 418 00:27:48,960 --> 00:27:53,040 Speaker 1: by other things and forget to focus on the patient. 419 00:27:53,680 --> 00:27:56,560 Speaker 1: And so that's the biggest thing new that I see 420 00:27:56,880 --> 00:27:59,560 Speaker 1: is we have to stay focused on that. One mission 421 00:28:00,080 --> 00:28:01,919 Speaker 1: was very impressed with that. I thought this notion that 422 00:28:02,320 --> 00:28:04,640 Speaker 1: if you started with the patient and you wanted all 423 00:28:04,760 --> 00:28:08,520 Speaker 1: the system to revolve around the patient, then you would 424 00:28:08,560 --> 00:28:11,600 Speaker 1: need the kind of information flow that a system like 425 00:28:11,720 --> 00:28:14,600 Speaker 1: sink Health provides. Could you talk for a minute, Jamie 426 00:28:14,640 --> 00:28:17,199 Speaker 1: about the way in which this is sort of a 427 00:28:17,960 --> 00:28:20,840 Speaker 1: really breakthrough era where we have the cloud and we 428 00:28:20,880 --> 00:28:24,040 Speaker 1: have a kind of connectivity that would have been seemed 429 00:28:24,080 --> 00:28:27,280 Speaker 1: magic thirty five years ago, but now it's sort of normal, 430 00:28:27,640 --> 00:28:31,080 Speaker 1: and it's gradually being applied to healthcare, and sink Health 431 00:28:31,160 --> 00:28:34,000 Speaker 1: is one of the real pioneers that's simply taking the 432 00:28:34,080 --> 00:28:37,919 Speaker 1: existing technology but making it applicable to the patient and 433 00:28:37,960 --> 00:28:42,320 Speaker 1: the doctor. Yeah. Absolutely so when we talk about the 434 00:28:42,320 --> 00:28:46,880 Speaker 1: cloud infrastructure that makes it available near real time, it 435 00:28:46,920 --> 00:28:50,680 Speaker 1: can now be delivered directly into the provider's workflow, so 436 00:28:50,720 --> 00:28:53,560 Speaker 1: there's no query, there's no facts to go find, there's 437 00:28:53,600 --> 00:28:57,480 Speaker 1: no pdf to scroll through. There's a number of advancements 438 00:28:57,480 --> 00:29:02,960 Speaker 1: in data and technology through advanced programming interfaces that allow 439 00:29:03,080 --> 00:29:06,760 Speaker 1: us to do some very magical things with interoperability and 440 00:29:06,800 --> 00:29:11,880 Speaker 1: electronic health records, but it doesn't happen without different governance 441 00:29:11,880 --> 00:29:15,440 Speaker 1: and policy efforts that health systems and states decide to 442 00:29:15,720 --> 00:29:19,640 Speaker 1: go all in on as far as benefiting individual people. 443 00:29:20,120 --> 00:29:22,600 Speaker 1: What are the challenges you face as you explain all 444 00:29:22,640 --> 00:29:26,200 Speaker 1: this in getting healthcare systems to adopt a system like 445 00:29:26,960 --> 00:29:30,520 Speaker 1: the one the sink Health offers. There's definitely resistance to 446 00:29:31,520 --> 00:29:34,920 Speaker 1: the data sharing efforts in some places. The two decades 447 00:29:34,920 --> 00:29:38,000 Speaker 1: that we've been working on health information technology, and just 448 00:29:38,120 --> 00:29:43,240 Speaker 1: as you talked about in paper Kills or the conversation 449 00:29:43,280 --> 00:29:46,800 Speaker 1: around health information technology from twenty years ago, there was 450 00:29:47,120 --> 00:29:50,240 Speaker 1: a promise of hit and it was very slow to 451 00:29:50,280 --> 00:29:54,000 Speaker 1: be delivered from various angles. Right, the electronic health records 452 00:29:54,000 --> 00:29:58,440 Speaker 1: didn't deliver what they promised. Medicare, MEDICAI got involved, slowed 453 00:29:58,480 --> 00:30:02,000 Speaker 1: things down and the rollout, So I think that's where 454 00:30:02,040 --> 00:30:05,160 Speaker 1: some of the resistance comes in. But then it is change, right, 455 00:30:05,200 --> 00:30:09,480 Speaker 1: It is changed to having just the information in front 456 00:30:09,520 --> 00:30:11,920 Speaker 1: of me that I took as notes in your last 457 00:30:12,040 --> 00:30:16,280 Speaker 1: visit or was from you know, my electronic health record 458 00:30:16,280 --> 00:30:21,200 Speaker 1: from my hospital to now community wide data and being 459 00:30:21,200 --> 00:30:25,000 Speaker 1: able to process that and understand it and utilize that 460 00:30:25,040 --> 00:30:28,000 Speaker 1: for better patient outcomes. It does take a shift, which 461 00:30:28,040 --> 00:30:30,560 Speaker 1: is where these integrated care models come in, which is 462 00:30:30,600 --> 00:30:33,840 Speaker 1: where population health analytics come in. All of those things 463 00:30:33,840 --> 00:30:37,000 Speaker 1: require a different set of data skills for providers than 464 00:30:37,600 --> 00:30:39,360 Speaker 1: you know, when Lynda and I went to school many 465 00:30:39,400 --> 00:30:42,840 Speaker 1: many years ago, we didn't have to do. So it 466 00:30:42,960 --> 00:30:45,760 Speaker 1: is a change. So things you're going to keep changing 467 00:30:45,800 --> 00:30:49,360 Speaker 1: and keep evolving. Where can people go to learn more 468 00:30:49,800 --> 00:30:55,040 Speaker 1: sync health dot org, CYNC health dot org to learn 469 00:30:55,040 --> 00:30:58,760 Speaker 1: more about health information, exchange, prescription programs, all kinds of 470 00:30:58,800 --> 00:31:03,200 Speaker 1: health information technology information there that's great, But provider can 471 00:31:03,240 --> 00:31:06,720 Speaker 1: also reach you directly. Am I right? Oh? Absolutely, yep, 472 00:31:06,800 --> 00:31:10,440 Speaker 1: there's a contact us or support at sinkhalth dot org. 473 00:31:10,680 --> 00:31:14,280 Speaker 1: I will definitely reach out to you well. Jamie and Linda, 474 00:31:14,560 --> 00:31:17,440 Speaker 1: I want to thank you both for joining me today 475 00:31:17,440 --> 00:31:20,880 Speaker 1: and sharing your personal stories both and working in healthcare 476 00:31:21,280 --> 00:31:23,880 Speaker 1: and also trying to solve the much bigger problems in 477 00:31:24,000 --> 00:31:28,360 Speaker 1: healthcare today by using data to create healthier outcomes for people. 478 00:31:28,800 --> 00:31:31,720 Speaker 1: I think what you're doing at sink health is really 479 00:31:31,760 --> 00:31:35,280 Speaker 1: an amazing breakthrough. It's something like Linda, I've been working 480 00:31:35,320 --> 00:31:38,280 Speaker 1: on for many, many years, and I'm seeing the technology 481 00:31:38,360 --> 00:31:40,920 Speaker 1: now come together to make it possible to have a 482 00:31:40,960 --> 00:31:44,640 Speaker 1: truly patience centered model. And I really look forward to 483 00:31:44,680 --> 00:31:47,400 Speaker 1: hearing more success stories in the future. Thank you Nude, 484 00:31:47,480 --> 00:31:50,200 Speaker 1: it's been a pleasure. Thank you Nute for having us 485 00:31:50,240 --> 00:31:58,680 Speaker 1: on your podcast today. Thank you to my guests, doctor 486 00:31:58,760 --> 00:32:02,760 Speaker 1: Jamie Bland, speaker Linda Apmeyer. You can learn more about 487 00:32:02,800 --> 00:32:06,560 Speaker 1: sink Health on our show page at newtsworld dot com. 488 00:32:06,680 --> 00:32:10,120 Speaker 1: Newt World is produced by Gingwish three sixty and iHeartMedia. 489 00:32:10,400 --> 00:32:15,560 Speaker 1: Our executive producer is Garnsey Sloan, our producer is Rebecca Howe, 490 00:32:15,960 --> 00:32:20,000 Speaker 1: and our researcher is Rachel Peterson. The artwork for the 491 00:32:20,000 --> 00:32:24,200 Speaker 1: show was created by Steve Penley. Special thanks to the 492 00:32:24,200 --> 00:32:27,680 Speaker 1: team at Gingwish three sixty. If you've been enjoying Newtsworld, 493 00:32:27,960 --> 00:32:31,120 Speaker 1: I hope you'll go to Apple Podcast and both rate 494 00:32:31,200 --> 00:32:34,320 Speaker 1: us with five stars and give us a review so 495 00:32:34,440 --> 00:32:37,800 Speaker 1: others can learn what it's all about. Right now, listeners 496 00:32:37,840 --> 00:32:40,640 Speaker 1: of newts World can sign up from my three free 497 00:32:40,720 --> 00:32:45,480 Speaker 1: weekly columns at Gingwish three sixty dot com slash newsletter. 498 00:32:46,040 --> 00:32:50,160 Speaker 1: I'm new Gingwich. This is Newtsworld, and this episode of 499 00:32:50,240 --> 00:32:52,600 Speaker 1: Newtsworld was brought to you by Sink Health