This months episode of “News you can Use” in the traditions of “Ask Me Anything” on HealthcareNOWRadio features news from the month of June 2022
You can read more about the series here and the concept of keeping up with innovating in healthcare. Please send me your suggestions on topics you’d like to see covered. You can reach out direct via the contact form on my website, send me a message on LinkedIn or on my Facebook page (DrNickvT), or on Twitter tagging me (@DrNic1) and #TheIncrementalist or you can click this link to generate a ready-made tweet to fill in:
I am talking to Craig Joseph, MD (@CraigJoseph) Chief Medical Officer at Nordic Consulting Partners. Thanks to sponsor Atlantic.net for supporting this episode.
This week we discuss the increasing instances of Ransomware and why healthcare has such a big target on its back (this is not new as I noted back in 2018 – The Feeding Frenzy of Hackers Around Digital Healthcare). As we discussed in our update from AMDIS – expect more security overlay to our activities in healthcare.
We review the HHS funding announcement of $80 million in American Rescue Plan Funding designed to “Strengthen U.S. Public Health IT, Improve COVID-19 Data Collection, and Bolster Representation of Underrepresented Communities in Public Health IT Workforce” and ponder if 0.02% of this government investment is really enough, and Craig wonders why the government needs to create a 70+ page proposal to standardize patient address (essential for patient matching) when the US Postal service already has a well established system for this
Listen in to hear about Doximity and their recent IPO for $4 Billion and the recently funded company Zus that Jonathan Bush is leading
Listen live at 4:00 AM, 12:00 Noon or 8:00 PM ET, Monday through Friday for the next week at HealthcareNOW Radio. After that, you can listen on demand (See podcast information below.) Join the conversation on Twitter at #TheIncrementalist.
Listen along on HealthcareNowRadio or on SoundCloud
Raw Transcript
Nick van Terheyden
And today, as I am every month I’m delighted to be joined by Dr. Craig Joseph. He’s the chief medical officer for Nordic consulting partners. Oh, hold on. Wait. I’ve got to do the sponsor. Sorry. No worries. In 321 Hi, this is Dr. Nick on the incrementalist and today I’m joined by Dr. Craig Joseph, the chief medical officer from Nordic consulting partners on news you can use. Today’s episode is sponsored by Atlantic dotnet, the award winning cloud hosting company trusted with securing critical data for over 25 years, their industry leading HIPAA compliant cloud hosting solutions are backed by a fully audited 100% service level agreements in Customer Satisfaction Guaranteed. Get started today with your free trial at Atlantic dotnet. Craig, thanks for joining me today.
Craig Joseph
I’m excited to be here.
Nick van Terheyden
So we’re just off bar and this visit. And I guess both of us excited to see each other in person. It’s funny, you look exactly like you do on
Craig Joseph
the TV screen. And you you actually look a lot better in person. I’m gonna say in real life, I thought you were a little pale and shorter.
Nick van Terheyden
I’m better. But to be clear,
Craig Joseph
I don’t. Then the opposite of what I just said. Yeah, it was exciting under any circumstances, we
Nick van Terheyden
want to see you. Yeah, I feel like pretty much anything could have happened on that trip. But it was just nice to have some real human contact with a range of folks and many old friends. So it was, it was a great time. So this month, talking about a range of things going on, I thought we’d kick off talking about ransomware. It feels to me that not only do we continue to see ransomware attacks everywhere, but increasingly targeted on healthcare. What do you what do you see? Well, I
Craig Joseph
think it’s the same thing. Every day hospitals across the country, really the world as well and are, are being attacked. And you know, that’s where the money is, hospitals are much more likely to pay ransom. If their data are encrypted. They have to, because they need to take care of patients. And so it’s also a place where it’s difficult, I think more so than in a lot of big corporations to secure their data. They have a lot of people who need access to the to things like the electronic health record, and to educate all of those folks about proper ways of securing their password of not falling for phishing attacks of those things, is more difficult, I think, than a bank or an insurance company. So there are prime targets.
Nick van Terheyden
You know, and the interesting thing about that, is that, if that’s the case, is there any scope to prevent or challenge this? I mean, if you think about this, you know, you’ve got this massive surface area of attack that is open, you provide critical services, your scope to sort of prevent and, you know, as I’ve been hurt to say, we humans are the weakest link in this. How do we protect is the sun some method? Or means that we can start to probe help folks prevent these attacks from occurring?
Craig Joseph
I think it’s a there’s certainly no one way. And as someone security expert once told me, if you really want to be 100% sure that no one’s going to attack your computer. Don’t Don’t plug it in. Right.
Nick van Terheyden
I just have to stop you right there. Even that is insufficient. I saw a paper that showed for an air gapped computer, it was possible to actually hack it using em. Technology an extraordinary Well,
Craig Joseph
no, no, no, I’m saying don’t plug it into a power source now.
Oh, yeah.
Yeah.
Craig Joseph
So the point being well taken that there’s nothing you can if someone really if someone who’s sophisticated, really wants to get in, they’re going to and it’s I think it’s just like preventing or minimizing your risk of burglary at your house, if someone really wants to get into your house, they’re going to get into your house, if they’re a professional, and they know what they’re doing, what you’re trying to do is make it difficult and and put up as many barriers as you can so that someone who’s just looking for trouble can go to the next place. And so it’s a combination of certainly ongoing training and education for your staff, ongoing attempts to stay one step ahead with the technology of when holes are are made public to make sure that you’re you’re patching them, and that you’re always up to date. With the latest software, sometimes being up to date with the latest software is bad. But that’s the exception, not the rule. And I think also there are policy things that we’ve seen a lot of this malware comes from Russia, or at least that’s what the United States officials have said. And so trying to make it more appealing for officials of certain countries to crack down on either, you know, cyber espionage or, or cyber stalking is going to be is going to be helpful, but it not one thing is ever going to fix this problem. We have to make it so that it becomes it becomes less lucrative, and also make it more difficult, right. So a lot of times these are not very sophisticated actors that are able to carry out very little lucrative, you know, encrypting of people’s data. So getting get making it more difficult, will be helpful. But yeah, I don’t think there’s a if I had the one solution, I wouldn’t be talking to you I would be you know, managing the building of my Island State.
Nick van Terheyden
Yes, exactly. I think we heard it. I’m this from one of the present presenters that if the one thing that you learn from all of this is that it’s just going to be harder to access systems, because we have to put in these two factor authentication, you know, constant sort of reminders to sort of preclude that. And I think what we need to see is some more technology being applied some automation, perhaps to sort of seek rather than trying to prevent the attacks. But you’re exactly right. This is a huge challenge. And it’s just this ripe platform that is open for opportunity. Which leads me to our next area. The American rescue plan funding act that just came out, offered a 80 million, I believe, was the number essentially designed to promote digital collection data bolster all of the underrepresented public health information technology, which on its own, you go, Well, that’s pretty cool. 80 million, the government’s taking public health and it seriously. Any thoughts?
Craig Joseph
Well, you know, public health has always been the, the the neglected stepchild of the healthcare system in the United States, at least probably in a lot of places, but certainly in the United States. That’s never one of the sexy things happened. And the well reimbursed things happened. And that was fine until it wasn’t. And last couple of years, we’ve seen what happens when your public health system is lackluster. And so we’ve certainly paid the price of not really having our eyes on what was going on with respect to COVID. And and two other upcoming threats. And so certainly 80 million is a great step in the right direction of trying to encourage all the individual, local state and the CDC, to to, to share data and to kind of be more cognizant of what’s going on. That said, I think that we had talked before the show about how much was in that entire grant, which was more than 80 million. What was that number? Again?
Nick van Terheyden
350 billion? Yeah.
Craig Joseph
So the total was 350 billion of which 80 million was for public health and it and percentage wise. I think that’s a small it’s a small percentage.
Nick van Terheyden
I think that’s the disappointing thing. So yes, it’s great. Yes, we need to focus on public health. Well, actually, no, not Yes, we must focus on public health. is probably the most important thing. We spend gargantuan amounts on healthcare. And we could spend much less if we actually did a really good job in public health and did prevention and created equitable access. And yet, out of that 350 billion, it was naught point 02 percent of the total, that for me is just very troubling. We really have to focus and spend the resources, you can’t do this without it. Great, we’ve put in 80 million, but is that really going to make some differences? Perhaps, but not significant? And certainly not persistent? So hopefully, we’re going to see more of that. Meantime, I think there’s been some focus on addresses and data cleanup, which you are looking at, right?
Craig Joseph
Well, I’m, I’m proud to say that I’m gonna say it out loud. I’m a nerd. And I’m sometimes fascinated by very, very technical issues that one would think, would not be that big. And so what you’re referencing is that the Office of the National Coordinator for Health Care it in the United States, part of HHS, is leading an initiative to standardize patients addresses here in the United States. And I think we’ve all seen that the US Postal Service has done this whenever you want, not all the time, but often enough, when I’m entering my address, when I’m ordering something online, or somehow giving someone my address, I might type in the my street address, and half the time I get a little pop up and it says, You type this, did you mean that? And usually what it’s correcting is I typed the word st out. And it’s saying no, no, it’s really capital S capital T. Isn’t that what you mean? And I’m like,
Nick van Terheyden
I just have to say, how come it’s only some of the time because I get it all the time?
Craig Joseph
Well, I’m clearly better at entering my demographic information. And you obviously
Nick van Terheyden
have caps lock on your keyboard, because that’s the only thing it capitalizes everything. But yes, you’re right. It always
Craig Joseph
pops. So it so when again, or the other problem, potentially, is that I don’t go to quality websites like you do. Be that as it may, it seems like the US Postal Service has figured this out, right. They have standard abbreviations, they capitalize everything. And that makes their lives much easier when they have automated technology that are trying to read these addresses off of the envelopes, and get them to where they need to go. And if it’s a if it can be in a standard format, it’s much better. We’re having the same problem and healthcare apparently, for reasons I don’t understand, we’re not able to just leverage the rules and technology that the US Postal Service has already developed. And we’re, we’re trying to develop them again, in terms of collecting patient information. And the reason this is important is not to be able to send out collection notices and bills, although I’m sure that’s a part, the main problem is in identifying patients. So a patient walks into the emergency department and gives their information trying to see Do we have this patient already in our database, or one hospital’s electronic health record, just trying to get information from another hospitals electronic health record, and say, Hey, we have this patient in our hospital, do you have this patient’s information as well, so that we can get their their test data and their medical history and such, and making sure that those are the same patients, we’re comparing many things, their name, their date of birth, and one of the things that we’re comparing is their street address. And if those are different, then the computer has a bit more difficult time and making sure that this is the right person that we’re trying to connect to. And it just, it was fairly astounding to me that this this is a problem in this day and age that we can’t just say, just like when any clue, you know, when we type in our address, and it’s not the way the USPS wants it. Why can’t we just take those same rules and apply them to the clerk that’s entering the information when the patient’s registering for their office visit? and say, Oh, I think you meant st not street under any circumstance. It’s fascinating. I think it was like 75 or 80 pages of recommendations to begin the conversation about standardizing patient addresses. So yeah, that’s what excites me. And I’m I’m proud of that fact.
Nick van Terheyden
For those of you just joining, I’m Dr. Nick the incrementalist and today I’m talking to Dr. Craig Joseph, the Chief Medical Officer for Nordic consulting partners. We are monthly news you can use. Just a reminder on today’s sponsor and get started with your free trial at Atlantic dotnet. The simple solution for HIPAA compliance cloud hosting needs? We were just talking about the H H s, or was it o n c? I forget. I think it was o n c address verification system, as you rightly pointed out that shows up everywhere. It doesn’t matter what do I order and they can deliver packages. And there is barely a time that I don’t have it show up. Why we can’t have that why we have a 70 Plus page document to recreate the wheel seems extraordinary, there has to be a better way of innovating in healthcare, and spending the $8 million. The government has generously provided from the digital health enablement from the American rescue plan funding package. So other things going on doximity went or has released its IPO paperwork, they call 4 billion valuation. We saw a little bit from those folks at the recent conference. Any thoughts? I mean, you know, my experience with doximity, the quiet sort of successful, long time in the making, but you know, over 300,000 active position participants, I think that was some accelerant to them with COVID-19. And telehealth, they really sort of provided an agile service that was quite capable for physicians with some clever features. And now they’re actually going public. That’s quite the valuation.
Craig Joseph
Yeah, I’m impressed. I’ve been a doximity user, I think many non physicians have probably never heard of doximity. It’s a company that I think they started off trying to be something like Facebook or LinkedIn for physicians, and so only licensed well not licensed, but physicians who are registered with the AMA, were allowed to get in again that and I’m not saying that you have to be an AMA member, but you can’t just say you’re a doctor that you had to prove that you were you were who you said you were and then you got to access and they have a lot of they started off with just a lot of little tools. They they had a cute little thing, which they still use, which a lot of doctors still use. So when you call someone from your cell phone a patient, you can call through doximity. And it will spoof the phone number to your so it looks like you’re calling from the office so that patients don’t have your personal cell phone, which a lot of physicians think is a good idea. So they have little tools like that. And they have a great place for storing your CME and a lot of physicians have just kind of signed up and use a tool here and there. And lo and behold, a significant chunk of us physicians have given their information to doximity and doximity, I think and has used that information for good not for evil. they’ve sold it to pharma companies, and you say, well, is that good? Or is that evil? I think it’s some reality. And, you know, we’re certainly not inundated with ads, but people do know how to get ahold of us recruiters. So hospitals and doctors offices, were looking for physicians leverage that a lot more than LinkedIn. And, as you said, they introduced an incredible tool for telehealth that physicians just adopted like crazy. And the problem was that the security through it wasn’t as great at the beginning when they when they first introduced it. And a lot of hospitals who are very sensitive to cyber security, as we mentioned, in the first part of the show, we’re not none too happy. But now they’ve updated that. And so it’s very easy to get on a call with a with a doctor. A video visit doesn’t have all the bells and whistles, but it works and it works great. It’s an instant access,
Nick van Terheyden
you know, doesn’t matter what the patient is in the tele console can be a telephone call, but also a video call for those folks that are equipped and it’s sort of one touch, you know, and they created a business model out of that, that was it’s free to get in, but there were some additional options that people have signed up and they’re actually creating revenue. So you know, fascinating and I, the feature you mentioned or didn’t mention that I think is kind of interesting is where your colleagues that you’re connected with have shown up, not so much in the news, which is what LinkedIn does, but actually on paper. So I see papers that folks have published or reference authors in that I find interesting to sort of keep up with, you know, some of my colleagues and my specialty so You know, for me, certainly useful features. But you know, I think a great story be interesting to watch and see where that goes. As we talk about public companies, I think that brings up Zach Hill. Have you heard of them?
Craig Joseph
I have heard of them. I think they want to be pronounced as Zeus health.
Nick van Terheyden
But it’s spelled Zed u x, or Z as you guys.
Craig Joseph
It is spelled Zed as, as we might say, outside of the United States, us. But I think they wanted to be called Zeus like the Greek god, Zeus. And actually, well, they’re they’re supposed to be an Eon there. Yeah, I’m not a spelling expert supposed to be any. And, you know, they created the company and started doing what companies do. And then someone tapped them on the shoulder and said, Excuse me, we’re, we’re Zeus health.
Nick van Terheyden
we’ve,
Craig Joseph
we’ve been Zeus health. So we’ve
got Oh,
Craig Joseph
we’ve got that kind of copyrighted or trademarked or whatever it is, that one does. So.
Nick van Terheyden
So that’s no. So now there.
Craig Joseph
And you’re making fun of them. And that’s fine. I think that’s a that’s appropriate, and they deserve it. But they don’t know
Nick van Terheyden
who’s who’s in charge. I think it’s fair game, right? Because he’s certainly known for his comedic behavior. Yeah. Right.
Craig Joseph
So Jonathan bush is the the CEO, and he is in health care circles, well known for athenahealth, which is a very successful tronic health record company focused really on smaller offices in the United States and potentially elsewhere. And so he has left that company A while ago, and this is another endeavor. And yeah, there, he certainly understands the health care industry in the US. He is his last name is Bush, he’s related to the President’s. So he has some good family connections as well. And he seems to be successful, the things that he’s trying to be successful at. And so we’ll see what this company does. They’re trying to be a marketplace for healthcare information. What does that mean? We’ll find out. I think the idea is not that they store data, but that there’s a centralized place for individual applications that are being created to, to work together in that kind of a centralized marketplace.
Nick van Terheyden
I and I’ve just got to say, you know, all credit to somebody to raise, I believe, 34 million, and I can’t quite tell exactly what it is that they do. So I may just be my inadequacies, but I didn’t hear too much detail marketplace. But, you know, there’s clearly something there. There’s a team, you know, investors have said, there’s some potential, I think, as we look at the digital health marketplace, you know, the explosion of activity, and lots of people that we talked about in the past that, you know, potentially going to fall off, there’s this, you know, failure, the Black Swan discussion from the last time. Interesting to see, I think, exciting, potentially, because, as I read the materials and what’s available publicly, allowing people to focus on the patients and not going after and accessing the data, that’s certainly admirable, you know, solves a lot of problems. So from my perspective, you know, looking forward to seeing it, let’s hope they can do it and do it quickly, because we definitely need it. And, you know, good news. We had 80 million in HHS that was invested in that. So that’s over 100 million at this point invested in focusing on digital health, which I see as the big enabler. I mean, this is the old mentation of the future of healthcare. It’s not replacing things, but I think it has to make things better, more equitable access, wider spread access. So I think all round good news, unfortunately, as we do, every month, we’ve run out of time. We would like to thank our sponsor today, Atlantic dotnet. Keeping your focus on the patient is essential and having the wrong cloud service plan can be costly. start your free trial of HIPAA compliant cloud hosting today at Atlantic dotnet. And of course, just remains for me to thank Craig for joining me as he does each and every month, talking about the latest and greatest news. Always a pleasure to see you. It was a great pleasure to see you in person. But always good to catch up and focus on what’s been going on Craig, thanks for joining me today.
Craig Joseph
As always a pleasure You’re on my side too. Thank you
