Navigating the Intersection of Healthcare, Law, and Cybersecurity with SHP's Julia DiGiacomo and Ami Patel

Discover how the intricacies of healthcare and law intersect as Julia DiGiacomo and Ami Patel from SHP join us to unravel the complex web of client relations and regulatory changes that impact the industry. Julia brings her expertise as a senior client representative into the spotlight, emphasizing the delicate art of nurturing client bonds that keep the healthcare machine running smoothly. Ami, with her rich background that spans from SHP to healthcare administration, sheds light on the nuanced role of independent physician associations and their influence on healthcare delivery. Our roundtable reaches a fervent peak as we dissect the FTC's recent stance on non-compete clauses and its potential ripple effects—from doctor's offices to the corporate giants like Epic.

The plot thickens as we navigate the murky waters of cybersecurity in the healthcare sector. With the FTC's Health Breach Notification Rule expanding its tentacles to grip health apps and technologies previously untouched by HIPAA, companies such as Google and Apple are now stepping into uncharted territory where patient privacy is paramount. As we unpack the industry's fortified response to cyber threats, including ballooning IT budgets and the whisper of government-imposed security guidelines, we draw from our own troves of experience in private practice to underscore the critical nature of impenetrable digital fortresses. This episode serves as a beacon for anyone vested in understanding the evolving landscape of healthcare, where law, technology, and personal narrative collide.

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Transcript

Aaron: 0:51

Well, welcome back to the podcast. This is a very special Aaron and Jason show, as it were. I'm here with my good friend and partner in crime, Jason Crosby. Jason, how are you doing today?

Jason: 1:04

Yes, I am the first Jay, but we're going to introduce another Jay part of the show today that I'm excited about.

Aaron: 1:09

That's right. So we're changing things up. Season four has been a whole lot of different changes, and two of those changes are sitting right here digitally speaking in the room with us Julia DiGiacomo and Ami Patel. They're SHP employees and you'll get to hear more from them in the coming episodes, but we figured this would be a great episode for everybody to meet the two. So, Julia, Ami, welcome, Glad that you're here with us.

Ami: 1:45

Glad to be here.

Julia: 1:47

Thanks guys. Yeah, glad to be here.

Aaron: 1:50

So, julia, we'll start with you, just because that's the name I looked at first. Tell us a little bit about yourself, maybe how long you've been with SHP and what you do.

Julia: 2:01

Hey, aaron, thanks. Yep, my name is Julia DiGiacomo. I have been at SHP for coming up on a decade, I guess soon for about eight years. I started at this company, you know, back in 2016 with enrollment, and I'm a senior client rep now.

Aaron: 2:22

So what does a senior client rep do?

Julia: 2:24

Well, we are kind of the catch-all, the glue that keeps us together, if you will. That's right, we're the account managers and point of contact for our clients.

Aaron: 2:36

So when someone needs services or they have a question or want to engage at SHP, they're talking to potentially you, right?

Julia: 2:44

Oh yeah, 100% of the time. If you don't know where to go or who to ask or what to do, you just give me a call. We are each of our clients have a designated client representative on the account, so we're always happy to help. Okay great, we are happy to client representative on the account, so we're always happy to help.

Aaron: 2:59

Okay, great, we are happy to have you on the show. Really excited. We love working with you. It's certainly you are delightful and someone else who is an absolute delight to work with so much. So she left and she came back again. Ami, what can you tell us about yourself?

Ami: 3:22

Yeah, so my name is Ami Patel. I have my master's in healthcare admin. Like Aaron graciously said, this is my second go around with SHP. I loved it so much I had to come back. I did spend a little over four years as a practice administrator over at an OBGYN office and then I came back to SHP in a different role than I was the first time I served in the IPA side, the first go-round, and now I am a client rep, just like Julia.

Aaron: 3:48

Now, maybe for our listeners who don't know, that doesn't mean a type of beer, correct?

Ami: 3:53

You know, an Indian pale ale is a wonderful type of beer, but unfortunately, this time we're talking about independent physician associations, which is also a great thing.

Aaron: 4:04

And that is a service that SHP does offer. That's something that we've done for a very long time, right, jason?

Jason: 4:12

Oh yeah, and you'll hear probably more about it Ami and Julia both helping out with our commercials that you'll hear during the podcast, but we do have a few of them in the state of Georgia and if you're an independent physician, reach out. We have a great IPA market just for you.

Aaron: 4:28

Okay, well, that is a great introduction. Julia and Ami, I'm so glad that you've agreed to join us on the podcast and listeners. Just so you know, from time to time it might just be Julia, or it just might be Ami, or hey, maybe it's just Julia and Ami and you don't have to hear us. So, as our podcast continues to grow and change, we want to make sure we stay relevant and engage with you all. So with that, jason, I think we need to jump into some headlines. What do you got for us today?

Jason: 5:03

yeah, so a week ago now, so probably two weeks from the time folks are hearing this. Obviously non-compete, and the ftc came out with their ruling on, Tuesday, the 23rd of April. There's a three to two margin, so it's pretty slim rolling there to ban non-competes. And obviously there's a lot of back and forth depending if you're on the hospital side, aha, ama side of things, but the theory being to help reduce overall costs. Ftc had some surveys, as they quote in some of their articles. They estimate they could lower health care costs by nearly $200 billion over the next decade.

Jason: 5:45

Then you, of course, have the physician burnout side of things. Right, that if folks, if the physicians, are obligated by way of non-compete, being able to move families or to a different environment just isn't feasible. Then you also have the hospital side. Why would they help bring in a physician to medical groups in the community or their own if they know that a physician can just up and leave? And so there's definitely going to be a lot more over. Well, it could be the next few years, who knows, before all this does take place and unwind. Um, you know you also have vendors. And then I found interesting folks like epic. You know epic has issue with it. For example, you know, if you've got uh providers that are able to do such, what intellectual property leaves, along with the provider in that community or, in this case, another software vendor vendor. So a lot to unfold. It's not going to happen tomorrow, but it's definitely something that's going to help sort of shake up the industry, which can be a good thing.

Aaron: 6:47

Man, I think this is going to drastically change the face of at least in system. In areas where you have two systems fiercely competing against one another. Uh, where you'll you'll see, they get tied into these contracts and they they can't leave to go to the competitor across town. They have to uproot their family and go elsewhere. Well, that that's going to be a day of the past. So, dr smith, you know he signs on with a big service and doesn't like it is working too hard and he wants to go over to the other system. Like obviously he wouldn't be allowed to, but that sounds like that's been tossed. Is that a correct understanding?

Jason: 7:31

Yeah, and I'll add to that. You know, keep in mind too it does not apply to nonprofits, which I think by last count was, you know, let's say, 50 percent, half the hospital market's out there, and so if it's not going to touch nonprofits because that status, who knows how much this will have some impact, but it does impact all health care workers, right, it's just not providers. We're talking about it's executives as well, and so you've got more concern from that angle, and so I imagine now we're going to get kind of the lobbyist ping pong match and kind of play that game for a while, but it's definitely going to shake some things up and some see a lot of provider feedback that I've read about seem to be for the positive and including the kind of the non-tangible side, the burnout side. Right, it's got that sort of if I'm not functioning well in my current environment, do I leave my profession? Is sort of the question being asked.

Jason: 8:29

Well, now, they don't have to. It's just let me go find another environment is a lot of the sentiment on the independent doc side of things. So lots of good conversation happens because of disruption. You and I have talked about disruption quite a bit on here, whether it's Best Buy or Walgreens. Well, now you've got something on the direct provider side.

Aaron: 8:49

Yeah, again, I think it's going to shake things up on the healthcare side. But good point on the whole nonprofit, because there's plenty of nonprofit hospital organizations and systems out there, so it won't affect them nearly as much, but I think it still will. It's a pretty big deal.

Jason: 9:08

I think Exactly. Even in the rural markets, where the smaller nonprofits exist, there's going to be some impact. You also have wages. The theory is, this will raise wages, which in the law markets, would be a good thing, right? Because again, it's just not providers, it's staff and the like, and so there's another sort of collateral impact that could be a positive thing, yeah.

Aaron: 9:31

Poach the good talent away by offering better pay and higher incentives. Without a doubt, I think yeah.

Ami: 9:39

I mean I think it makes a big impact for physicians and you know that do have non-competes. Now I know working in OBGYN it was rough trying to get a new doctor on because there were a lot of non-competes in our area. They'd have to move, you know, two hours north to Charleston and be a laborist there and that affects patients. Because patients I feel like it's really hard to find a doctor that you really click with and if you do and they have to move away from the area, that I feel like that affects patient care. So non-compete I get why hospitals, you know health systems want that but in the long run, if it's all about patient care, why do we have non-competes?

Aaron: 10:24

Bingo. That's exactly right, ami. There's been such a push by the federal government on improving patient care, closing the patient loop, and then you have these non-competes that not just break it from a holistic of care standpoint but from that personal relationship, particularly with OB-GYN, that that's a very highly specialized and requires a deep relationship with your provider and that's taken away because of a piece of paper.

Ami: 10:57

Yeah, I agree.

Aaron: 10:58

Oh, I, I. I want to pivot to something else. The FTC has been busy folks, so they came out and they've made changes to the health breach notification rule. Now this is not to be confused with Office for Civil Rights' HIPAA notification breach rule. Those are two separate things and that's where it does get a little confusing.

Aaron: 11:23

I think we all know about Change Healthcare's data breach by now. If not, you've been living under a rock and so, because of their data breach, it brought about this change from the FTC. So the FTC is clarifying their rule regard to health apps and similar technologies that are not covered by HIPAA. So vendors of personal health records and related entities not covered by HIPAA are now mandated to notify individuals, the FTC and, when applicable, the media in case of an unsecured, personally identifiable health data breach. It's a mouthful to say, but we've all used, like Fitbits and other health-related monitoring device Heck. My phone has a health app that I can put in my calorie intake and my daily weight tracker and all that. All of that previously was not required to be reported upon or treated like. It was PHI, as in HIPAA, but now it is yeah.

Jason: 12:36

So the FTC has obviously been quite, quite busy. But you know, in both regards, whether it's the non-compete side or, as you just mentioned, on yours, it's definitely relative and timely. I'm just curious about the how far reach do you go with? Something like that? But there's definitely somewhere that they need to step in and help with.

Aaron: 12:57

Well, I, I feel like the FTC is doing this. The cows already out of the barn, right, and now we're trying to close it. You have all these different health apps, which are great, don't get me wrong, I use these apps. It helps me keep track of my steps and you know, again, like weight and things like that, those aren't really important things, but it is health information, right, and HIPAA doesn't apply to these people because they're not actually providing the health care, but they are recording it. And so the FTC finally has gotten around and again these big data breaches, I think, push them over the edge to actually doing something about it, essentially, creating HIPAA type reporting rules and protection requirements, even though these are not HIPAA covered entities. So this is big. So you know, google, apple, microsoft, garmin, just to name a couple right off the top of my head these companies gather health information. Now they need to be protecting it much in the same way that your doctor's practice or hospitals should.

Jason: 14:12

Rightfully so. Hopefully this time it's in a proactive manner versus reactive like we tend to be. You know, technology is only going to continue to advance consolidation, HIEs, AI, etc. Etc. So the more protection we can have up front, I think, the better Right.

Aaron: 14:25

So, jason, in that same vein of the FTC making changes to healthcare, with all these breaches and things like that, some good news is that the healthcare industry seems to be taking this seriously. So in the last what five years, we have seen a massive increase of cyber attacks, a massive increase of cyber attacks. Honestly, it feels like there's not a day that goes by that we don't hear about some sort of data breach, some sort of hack, something along those lines. And we've seen, in the last several years, an increase in the IT budgets across the board. Across the board. And so we're seeing, let's see, 7% increase to IT budgets in the last three years, and that doesn't sound like a lot, but we're you know they're taking the average budget in a 7% increase. So I guess to my point, is it? It feels like again cow out of the barn. We're trying to close it. Seven percent doesn't feel like enough to close that gap, but at least there seems to be a response yeah, and you gotta start somewhere.

Jason: 15:44

I'm, I'm, I'm of mine. Even the non-compete side, right, While this ruling, which does take an effect probably here in a few months I think it's like 120 days, 90 days after the ruling comes out it'll take effect. What I liked about it is it doesn't impact existing non-compete. So there is a stair step. It doesn't just hey, we're free for all step. It doesn't just hey, we're free for all.

Jason: 16:10

But the FTC understood they got to step in. When we have a shortage on the physician side and disgruntlement and satisfaction issues and wage and trying to catch up with inflation, et cetera, et cetera, you got to take some kind of steps. Healthcare costs keep going up, so they step in. I see the same sort of logic with what you're talking about on the IT side of things. If IT breaches concerns but usage is only going to go up, where's the staff and the wages? Where are they to keep up with that increase? You got to be able to attract the talent into the industry if there's going to be just further use of it, right. So I kind of see it as a good thing.

Aaron: 16:44

Yeah, and I kind of wonder when will the federal government come in and start mandating security minimums? So I think that's the next thing to probably hit will be particularly once we get through this whole change. Healthcare thing, which is, at least as of recording, still sort of unfolding we're learning more about it and there's still payment disruptions and all that. We're learning more about it and there's still payment disruptions and all that. I fully expect the federal government to have some sort of thing to say directly in response to this. Either the really big systems need to beef up the security better or any HIPAA-covered entity is going to need to beef up their security. So we live in interesting times. So, ami, throwing to you you've been in private practice more recently than I have been what sort of emphasis was there on cybersecurity in the clinic?

Ami: 17:37

Yeah, we had a wonderful IT company that kind of provided that security for us. Let, we did have a little bit of a scare. We had a local health system here that did get hacked and so we were a little afraid because we had access to their system and it was connected a little bit through our system and so we kind of had to make sure that none of our data got leaked in that situation as well. But we have again, we have a wonderful IT that was able to make sure that nothing hadn't happened. So it is a huge, huge part in private practices and I do see that there has been an uptick in hospital. You know cybersecurity threats, so I think this is a good you know move by the FTC.

Aaron: 18:38

Your practice wasn't huge, but would you say this is regardless of size of practice.

Ami: 18:44

Oh, absolutely. I think, regardless of size of practice because you know smaller practices they may not have the budget or the ability to hire, you know, external IT companies or anyone that kind of looks over if things are being protected as they should. So I think every practice in every hospital should really make sure that they are protected on that front.

Julia: 19:08

The other part of this, which this is obviously a good move, a step in the right direction, of having our information more protected as a patient or a practice manager, whichever perspective you take this from. The flip side of it is the cost to do this For smaller practices. The cost to keep up with higher protection, and the tech that it takes to do this or outside companies, though, does increase over time, so that's going to happen one way or the other. Increased regulation is a good thing on it, but there is a side of if, from a practice standpoint, what costs are are going to be implemented, and that's just growing in our world.

Aaron: 19:55

Yeah, yeah, no doubt, the the the threats are only increasing, right, the more people use the internet and the more reliant we are on you know, a single hack and bring an organization to their knees and literally potentially cause them to close their doors. Alrighty, that's it for the headlines. We will be right back, okay, so welcome back to the podcast, Jason. What can you tease our audience with? We got some really exciting episodes coming up here over the next month. Almost. Let's talk about this.

Jason: 20:42

Yeah, our next couple of episodes really excited about a few reasons why they include two former client of ours out of the Midwest market Kelly McEnmarble and Sherry Rosary.

Jason: 20:55

Both were CEOs of large practices in the South Bend area where we were engaged this is going back to 2018, 2019, to help them form a clinically integrated network Sherry at Allied Physicians of Michiana and Kelly at the South Bend Clinic and those two ladies recently wrote a book and so we have two interviews coming up where Mike Scrivener and I talk to them just about their CEO experiences and where they see the industry going. But I think even more exciting was the book they wrote that our new A&J here, me and Julia, spearheaded a great interview, basically a book review, with the two and where we dive in deep on the ins and outs and the nuances involved with their book. So a little teaser you want to know tons of experience, I want to say between them 50 to 60 years as CEOs and also now authors of a very good leadership type of book. You'll want to tune in for those two episodes.

Aaron: 21:55

Julie and Ami. Obviously we don't want to give anything away. We want to encourage people to listen to the podcast. Don't want to give anything away. We want to encourage people to listen to the podcast. If you had to pick one highlight, what was something? Whether it was recording the podcast itself or your interactions. What were some highlights you'd like to share?

Ami: 22:13

I think they offer great advice for young individuals coming into health administration and I think that the stuff that they the examples that they used with their own teams and their own practices is just a wonderful experience and something I wish I had known before I'd gotten into practice management. So it was a wonderful interview with them and I think everyone should read their book because it's definitely an amazing, amazing book.

Julia: 22:42

Yeah, if you want a book that summarizes leadership from years and years of experience and you wanted to get it down to a hundred pages, get this book. These ladies did a fabulous job interchanging between each other and speaking to their prior history of difficult decisions and players in the healthcare industry and how they navigated through those things and the lessons they learned along the way, and also friendship that they gained too. It was an amazing read.

Aaron: 23:21

Yeah, it's one of those stories where, like they were technically fierce competitors right and now they're best friends.

Julia: 23:31

Yeah, exactly, and you don't see that too often. You know, especially in the healthcare industry, competition is fierce, whether it's with a payer or you know your local administration it's. It's a tough world out there and it can be a tough world, especially in the market that they were in.

Aaron: 23:49

And, and their book is the is called Two Rivers. We'll have some information linked in our next episode about our two interviewees, but we'll also link to the book in our show notes here. So with that, jason, I think that wraps up the episode. Anything else you want to share with our audience before we go?

Jason: 24:17

Yeah, we've got just a few more episodes left of the season, of course, the ones we just mentioned. Matt Usher, who we've talked about before, has been on the episode before. We'll have a halftime check-in on your health plan assessment. That'll be probably the 1st of June, so we look forward to wrapping up another good season.

Aaron: 24:37

Alrighty Well, julia Ami. Thank you for joining us, jason. Alrighty Well, julia Ami.

Jason: 24:45

thank you for joining us, jason, I guess.

Aaron: 24:47

Thank you for joining us.

Ami: 24:48

Appreciate it, thank you.

Aaron: 24:50

Alrighty folks, we'll see you next week. This has been an episode of Beyond the Stethoscope Vital Conversations with SHP. If you enjoyed this podcast, please be sure to rate and share it with your friends. It sure helps the show Production and editing by Nala Weed.

Jason: 25:09

Social media by Jeremy Miller.

Aaron: 25:11

And our co-hosts are me, aaron C Higgins and Jason Crosby. Our show producers are Mike Scribner and John Crew.

Jason: 25:19

Thank you for listening and we'll see you next time are Mike Scribner and John Crew. Thank you for listening and we'll see you next time. Yeah, I was going to ask this before. I'm going to ask it again Of these ladies, however, toilet paper over or under.

Ami: 25:34

Over Over.

Jason: 25:36

Thank you. Who puts it under?

Aaron: 25:40

I've got to say, though I find it under People who enjoy mullets, that's who puts it under. 've got to say, though I find people who enjoy mullets, that's that's who puts it under.

Ami: 25:45

Oh, now I got a question back to you guys do you pour the milk before the cereal or vice versa?

Jason: 25:53

cereal first yeah, what twisted universe is that that people do milk first?

Ami: 25:58

I have no idea I'm a milk first person that does that.

Jason: 26:01

Wow, yeah, I don't even know what to say to you yeah, do you also pull wings off butterflies?

Ami: 26:09

I will say I'm doing better about pouring the cereal first. I'm trying.

Aaron: 26:13

My friend called me a serial killer so I'm trying the other way around now, that's good, good to know good to know well, now our audience knows what sort of person we're dealing with.