President and CEO of AHN Discusses Changes in Health Care Practices Amid Covid-19.

Welcome to Disability Matters with your host Joyce Bender. All comments, views, and opinions expressed on the show are solely those of the host, guest, and callers. Now the host of Disability Matters, here's Joyce Bender.

Hi everyone, welcome to the show. Hope everyone is staying safe and healthy today. Well, first I have to have a special shout out to Yoshiko Dart. Yoshiko, lead on, Yoshiko. She is the wife of the late Justin Dart, who was a real leader to get the Americans with Disabilities Act signed, and this year is the 30th anniversary, and I am committed to never forgetting him in our history. And hello, Richard and Gang Young, my two friends from the State Department, one in Uh, Seoul, South Korea, and Richard in Okinawa. Now, if you missed my show 2 weeks ago, it was live from the embassy in Japan. You've got to hear that show. You've got to hear it with all the interpreters. And if you go to my website, you can hear it, or if you go to Apple or Spotify. Oh my God. Historic. So awesome. Sorry, I had to take a little drink of my favorite thing, which is coffee. Um, now I also have to say hello to all of my, uh, countries that listen to the show. Oh my God, we have listeners in 7 17 countries, 17, the largest being China. Is that amazing? So to everyone listening to this show, even in countries there are only 1 or 2, you know what? It means so much to me. You are helping me spread the word about quality of life for people living with disabilities. And you know, I always tell you, one person can make a difference. One person can start a fire. So whether you're in Finland or in China, thank you so much. Tell everyone else about the show. And to our very special sponsor, Highmark, who has been the sponsor of this show for 4 years. Can you imagine that? And Peoples Natural Gas, who was a new sponsor, Wells Fargo and the Employment Options. Thank you so much. So we all know I love Highmark. If you've been listening to this show for the past 16 years, you know Highmark helped me start the company. If it weren't for Highmark 25 years ago, there wouldn't be a Bender Consulting Services. And you know, think about what that company has done. I'll bet when Bill Lowry, who sadly passed away, said yes, Joyce, I'll bring on those 6 people and keep them on contract for 3 years. Had no idea that I would be speaking in Indonesia and South Korea and Japan and Panama and Kazakhstan, and this week even doing a presentation for Tunisia about employing people with disabilities. It's amazing. And our guest today is amazing. I want to tell you, I love this woman. She is very powerful and very well known nationally. She is a great supporter of mine and most importantly advocate for people living with disabilities. She is fantastic and it's such an honor to have a Highmark CEO of AHN, with us today. Hello, Cindy Hunterfeen.

Hello, Joyce. That is the best introduction I've ever had in my life. Thank you very much. It's an honor to be with you today. Thank you.

Well, it's an honor to have you with us. And before I ask you these questions, I want to tell you something on behalf of everyone in this country, especially though In Western Pennsylvania, the people who had COVID, they came to your hospital. I know for many people how you worked around the clock. I remember the day I called you at the beginning of this event, this terrible pandemic, and you said to me— I said, "Oh, Cindy, you are so busy," and you said, Joyce Bender, every day I'm fighting to keep someone alive. I will never forget that ever. And you and everyone at the hospital and all your other centers, what champions you are. So on behalf of all of those people, thank you.

Thank you, Joyce. Thank you for that.

So Cindy, let's hear about you. Um, we're so lucky we have you in Pittsburgh, but you weren't always in Pittsburgh. So how about if you tell all of our listeners a little bit about your background, what you did before— hi, Mark— and how you came here and how you feel everything you did prior prepared you for this role.

That's— okay, that's a great question. So, I've been in healthcare my entire career, nearly 40 years now. I spent the first 36 years at the Cleveland Clinic in Cleveland, Ohio. Many of you have probably heard of it. So, this is officially the second job I've ever had in my life. I came here in early 2016. I have to say that I had an absolutely wonderful career at the Clinic. It's an amazing organization. I grew up there, literally, and I still have, you know, many, many, many friends and colleagues there that I talk to nearly every day. It's hard to leave a place that you've been at for so long, but I came to a wonderful organization. In that position, I was really responsible for helping lead clinical operations throughout the organization. So that would have been hospital operations, physician practices, operating rooms, hiring of physicians, all that kind of stuff. What I really hadn't done was a financial turnaround of the magnitude that was required here in Pittsburgh. But I knew Joyce Bender from the, almost the first minute when I started talking to the physicians at Allegheny Health Network. That this was gonna be the place that I was gonna call my home for my second job because I wanted to help them so badly. You know, they went through bankruptcy, they were coming out of it, and they just needed somebody that was going to believe and support them. And just a very, very little bit about the Cleveland Clinic, you know, the clinic has a model that is called physician-led, which means they have physicians in leadership positions all the way to the top, to the CEO position. Physician, and it— that's the model that I grew up and really appreciated, and I knew that we needed that kind of model here to put the physicians in roles where they would be making decisions about where our system needed to go. They needed the confidence that their voice was going to matter, so I came here because of that and also because of the opportunity to work with a major payer, Highmark, and be a part of something great, which we call transforming healthcare, and that's the work that we're doing right now. That's a little bit about my history.

Oh, wow. What an impressive background at Cleveland Clinic, but I'm glad you came here. So, I'm glad we have you right here in Pittsburgh. So, Cindy, you're the CEO of AHN. How large is AHN, and could you explain to our listeners what that is? What is the Ali'ini Health Network?

So Allegheny Health Network is part of Highmark Health. Let me just tell you just a quick second about them. So it's— Highmark Health is the parent organization, which is, by the way, the second largest, what we call IDFS, in the nation. Now, what is IDFS? That's the Integrated Delivery and Finance System. There's several of these throughout the country, but none nearly as big as what we have. And that's really the combination of the insurance company and the provider system. An IDFS. So Highmark is based in Pittsburgh, employs about 35,000 people nationwide, and serves about 50 million Americans in all 50 states, by the way. Um, Allegheny Health Network, which is part of Highmark Health, has 13 hospitals along with ambulatory surgery centers, health and wellness pavilions, and physician offices. We employ about 21,000 people, including 2,500 physicians. Physicians. And as a lot of you have seen if you live in this area, we're continuing to grow. We've done a lot of new buildings that you've seen popping up around Western PA over the past 2 to 3 years, really with the intent of adding more advanced medical and surgical capabilities out in the neighborhoods close to where patients live. That's our whole goal, moving care close to patients so that they don't have to travel. Quality care. Close to our patients. And I think we've done a really good job of doing that.

Well, I mean, you have a state-of-the-art also cancer center that you recently put in place. And I, hey, I have to, I can't not say this, Titanium Man, Dr. Timothy Sauber. If you live anywhere in Western Pennsylvania and you need a knee replacement, this is where to go. I mean, I had a knee replacement there and it's, you know, a joke with all of my friends because now, you know, I'm walking miles and, um, wow, he just is awesome. So, new knee, hip, Titanium Man, that's where you go.

Timothy, he's a great guy. Great, great.

Yeah. But you do have so many areas. I just want to mention one of them, your Wellness Health Pavilion in Wexford, which I go to. Wow, it is so impressive. I mean, you go into a building and it's like everything, everything is there. You know, all the doctors or the specialty doctors you need or x-rays you need, or I mean, and it is, Everyone there is so friendly. And I just wanted to mention this, uh, anyone listening to the show, I mean it, you will not believe how excellent that facility is. And I'm sure you get compliments about that all the time.

We do, Joyce. I mean, it's not only a beautiful facility, um, and a great location, but you know, that's where our next new big hospital is going to be opening in probably September of next year. And it's just absolutely gorgeous. And the care that that hospital is going to provide is going to be like, um, nothing really probably any of us has seen. I've never seen anything like it. It's really— we're building our new hospital, um, around what we call a concierge model, so that patients, when they're admitted there, will have the ability within their rooms— everything's private rooms— and you have the ability to order room service. You can adjust your temperature. I mean, it's really going to be just a place that you not only get great, great clinical care, but the time that you spend there, you'll feel really well taken care of. So I can't wait for that to open.

So we can show that off. Oh, that's awesome.

I know.

That's awesome. And you know, so you know this, what I love about Highmark and AHN are the people at the top. I say that because, you know, in my 25 years since I started Bender, It is all about the people at the top. It really is. No matter what corporation you work for. And I just want you to know, every one of these people, every one of them are so dedicated to what I do, but really just to kindness, to caring about people. And it's so refreshing to be able to say that. And of course, Cindy, you are one of them. As a matter of fact, I've told this story on the radio show and I've told it when I speak at conferences. Here's what I mean, okay? I go to, uh, I speak at an event at Highmark, and I speak, and then I go sit down, and then comes this beautiful woman to speak, and it's Cindy Hundorfeen. And she had just heard me talk about how, uh, Highmark and David Holmberg stood behind me. Now, I am not kidding you, this is what she did, and this is when I said, that's it, I want to be friends with her. She says, from the 'Front,' she says. 'Joyce Bender.' Now remember, I didn't know her. 'Joyce Bender, I heard what Highmark, I heard what David has done, and I want to make a commitment right now that I'm going to hire people with disabilities from you.' Now I ask you, find a CEO that does that. I mean, is that not amazing? Cindy, I still remember that as if it was yesterday, and you carried through on your promise.

Well, Joyce, I remember like it was yesterday too. I remember that day very clearly, and I was so just— I mean, I was just taken with what you were talking about and how passionate you were about promoting people with disability. And I felt the same way. And I remember sitting there thinking, gosh, if Highmark is doing so much work in this area, there's no reason in the world why Allegheny Health Network shouldn't be doing this too. And that's why It was just— I mean, it came from the heart. I want you to know that, but I think you did know that. And, and I knew I was going to be friends with you from that day on too.

Well, good for me. That— well, that is wonderful for you to say that. It's an honor to have you as my friend. But she did do that. She did this in front of all these people, didn't know me, and she carried through. And the first person they brought on board an AHN is a person who is blind. First one. I say that because all of you would know that today only 19% of people with disabilities are employed today. 19%. I just read about this a little bit ago, which is so sad to know that, but you know, only 30% are counted in the workforce. So to have someone do this, as you well know, if you're blind, you know how hard it is to gain competitive employment. So that was a wonderful thing that happened. And as I mentioned earlier, Cindy, you know, you've done so much as a leader. I know from David Holmberg how he told me how you worked tirelessly during this, which is still happening, of course, this COVID. A pandemic, but what have you done at your hospitals to protect, for example, people that come in, you know, even in the lobby, wherever they are, to protect patients or at a wellness pavilion from the coronavirus?

Right. Well, we've done, you know, it's probably too much to ever talk about on this show, and really honestly, probably things that all healthcare systems are doing. And one of the beautiful things about this, I will say, that came out of this is that hospital systems, I think for the one— maybe for one of the very first times, started working together in Western Pennsylvania. And they had never really done that before because we had a common purpose: protect our patients, protect our employees. And we all needed and wanted to do that, and we needed each other's help to do that really, really well. But, you know, looking back at the beginning of February. I remember one of the first things that David Holmberg said to me when this— when we both looked at each other and knew this was going to be a big problem. He said, you know, forget about the money. We're going to do whatever it takes to make our patients, our members, our employees, everyone safe. Everything else goes out the window. And it really gave us the freedom to be able to do what we needed to do. And not only that, but Highmark leadership were absolutely key in helping Allegheny Health Network through the pandemic. They used all of their resources to call people that they knew within Pittsburgh and outside of Pittsburgh to help us acquire personal protective equipment. I mean, everything that we needed in the way of gloves and masks. And without them, it would have been probably a lot more difficult. And not only that, a lot of people don't know this, but because we were able to get so many supplies in, because of Highmark's relationships, we were actually able to share a lot of our supplies and equipment with other community hospitals that in normal days you would consider to be a competitor. In my mind, during this time, there's really no competitors. It's everybody just kind of working together for a common good. So we were able to give our equipment and supplies away to some of the hospitals that really needed it even worse than we did. But patient safety continues to be top priority priority for us. We talk about it every day. We've implemented really vigorous cleaning standards in all of our facilities, patient screening standards, you know, visitor standards, and remote testing sites, all with the idea of keeping patients as safe as possible. And even though we've reopened a lot of our facilities and, you know, are back to performing surgeries, people are still understandably nervous. Our volumes have really returned to almost normal in most of the areas, definitely not in the emergency departments. I think people are afraid to go to the emergency departments. They are starting to return to the physician offices, but I'll talk to you more about telehealth. That has played a big factor in how we're seeing our patients too. But I guess my message would be, if anybody's listening, if you're feeling ill, if you're sick, Don't hesitate to go to your doctor for fear of contracting this because I think patients are probably staying away when they probably shouldn't be.

Yeah, out of fear. Out of fear.

Right.

And before we talk about the telehealth, 'cause I wanna talk about that, how about the teleworking? How has it been for you?

Oh, it's good. Yeah, it's gone really well. We moved 3,000 of our employees really the people who were supporting our office functions, because most of the people in the hospital, they can't work from home. So hospitals, everybody came to work. But our office functions, purchasing, finance, HR, those kind of things, we moved about 3,000 employees to what we call work-from-home environment within just a few short weeks back in late March, early April. And it was really incredible that we were able to do it that quickly. And we still have about 1,000 people working remotely, but everybody just worked together to make it happen. We got all the right equipment and got everybody trained up to do that. And really the productivity has been high and we haven't had a lot of complaints from our patients. So, so far it's working out pretty well.

Well, you know, just as you said, I know the majority of people would have to be there But I do think corporations have seen, including Highmark, that people working from home are as productive, if not more, than when they are at work. I think that has been a surprise to a lot of people, and it's been wonderful for people with disabilities that live in rural areas that before really had a hard time getting any company to consider them., you know, working at their home. And now that door has become open for them. So that's really a good thing. So let's talk about that telehealth. Boy, you really blew it out of the water. I mean, this went from little to gigantic overnight.

I mean, who would have thought that that would have happened like that? Because, you know, when we started canceling all the elective surgeries and in business, we knew that we had to make a really quick transition to a virtual form of healthcare, telehealth. And we were able to really train every clinician in our network in about a 1-week period. I mean, think about it. That had to have been close to 3,000 people at least. And by the middle of March, we had addressed all of our network issues and hardware needs, and then transitioned pretty much everything to video and telephone visits. So prior— think about this— prior to the pandemic, we wanted to do telehealth, but we were really struggling to get traction with it. And despite having services across more than 37 different specialties, we were probably only doing about 200 video visits per month. And by April, that number went to 48,000 visits per month. You think about it, we went from 200 to 48,000.

Oh my God. Wow. That is unbelievable.

And the thing is, too, is that the patients, we ask them to rate their experience, and they really have a really high level of satisfaction with these visits. It's well over 90%. But the interesting thing is that the telehealth volume has really started to decline, and that's nationwide, not just at AHM, since the physicians offices have opened up. We expected that to happen, but probably not to the extent that it has. So, you know, we're really working hard to try to keep a lot of the telehealth volume up for our patients just because we want them to recognize that this is a new way of getting treated without the necessity of actually going somewhere. And I think it'll take a little while for that kind of, you know, that process to lock in, but we're going to work really hard to try to get that done. I just don't want people to move around if they don't have to. And if they want to, it's a different story, or if they need to, it's a different story. If they don't have to, then we need to teach them a better way to do it. So we're working on doing that right now.

Well, and sadly, as I say this sadly, many of the scientists are saying that, you know, COVID will be worse during the winter months because of being indoors and the flu, etc. So I'm sure that people that don't want to go out will see the benefits of telemedicine.

I think so, Joyce. That's why, you know, we're not going to let our guard down. We're going to keep everything in place, just like, you know, we have 48,000, uh, fine, just like we did. And, and we're not— because I have a feeling that we're going I think everybody's gonna probably need it, but it's a good service. And of course, you know, everybody's providing that right now. So regardless of the system that you go to, I think people should take advantage of that.

Yeah. And, you know, it was faster and more convenient for me. And whether it's a physical or just something, you know, an abrasion or whatever it is, or whatever it is, no matter what the ailment is, If it's not something that's, you know, so serious that you have to be there, of course, in person, it is awesome. This telemedicine— not only did my doctor do a great job, she then called me the next day to check on me. So I mean, that's great. Yeah, I think it's— I just think it's great for everyone, you know. And, and for many people, especially going through this economic disaster, you know, just the ability to do this from home and not have to drive somewhere and pay for parking, right, um, is, is an advantage for people. And I, I think it will continue. I think that it will continue because people see, uh, what an advantage it is for them. I think it's a revolution. I really do.

I do too. I do too. Definitely less costly. And I think that as our clinicians teach each other how to do it better and what the possibilities are, I think it'll just continue to increase and increase for sure. I know it will too. Makes sense.

I do too, I do too. Well, hey, it's on the half hour and as you all know, every half hour we have our news break. So, Perri-Jude Ratajkic, who handles our news from Advocacy Matters, Hi, Perry, how are you?

Hi, Joyce, uh, it's, uh, I'm doing great. It's good to be here. Uh, we're all gearing up for the November election, and, uh, Advocacy Matters Today wants to clear up some confusion about voting, especially here in Pennsylvania.

Let's go, let's hear it.

So voting has already begun across the country in so many states. And it's begun in Pennsylvania. Philadelphia has already mailed out over 100,000 mail-in ballots, and they're distributing more this week. I've got notice in my own county that my mail-in ballot is coming soon. So Pennsylvania is one of the key states when it comes to casting and counting votes. It's one of those states that everybody is watching. We've had some legislative changes, some court challenges, and some judicial decisions here in Pennsylvania. So there's a lot of information out there. So it's important that individuals with disabilities really pay attention and, and stay tuned because there could be more changes down the road because there are some appeals to some of those judicial decisions. The best way to keep informed is at www.disabilityrightspa.org. One big change, first time, here it comes, accessible remote ballot marking system. So after Disability Rights Pennsylvania and a private co-counsel, we filed a lawsuit to challenge inaccessibility of mail-in and absentee ballots for blind voters. Department of State here in Pennsylvania have agreed to implement a system that allows blind voters and other voters with disabilities to vote via the web. So eligible voters can be sent their ballots electronically, use screen reading software, and mark their ballot private and independently. So of course at disabilityrightsPA.org, we have a link for all the instructions. Now I'll tell you just really two instructions you have to pay attention to. First, you will have to request a mail-in or absentee ballot. You have to do that. You have to go through that process. And then within 24 hours, You're going to have to fill out a form to apply for this accessible ballot. So you're going to have to do that. You're going to have to ask for an absentee ballot. You're going to have to also ask for an accessible remote ballot marking system. You'll have to do both of those things within 24 hours. And if you go to our website, you'll find the instructions through the votespa.com website. So that's important. First time, lots of instructions. You'll have to take it step by step, but you'll be able to take care of that. First, apply for the accessible remote ballot. Second, then go get an absentee ballot form, mail it in, and you'll be set to go if you follow those instructions. Second very important thing, the judge— Pennsylvania Supreme Court ruled on this. Just last month. We have a new term in 2020, it's called naked ballots. What does that mean? It means if you're voting by mail, I don't care if it's through the accessible remote ballot marking system or you're just voting by mail, you have to use the secrecy envelope. Why do you have to use the secrecy envelope? There are two envelopes. There's the secrecy envelope to put your ballot in, and then you put that envelope envelope into the larger envelope. You have to use that envelope and sign it because the Supreme Court of Pennsylvania ruled that is part of the official ballot. So you have to use it. If you don't use it, your vote's not going to count. So please remember to vote with the accessible— uh, please remember to vote with the, um, secrecy envelope. We have a new deadline. Uh, it's being challenged in court, but right now if you get your ballot postmarked by 8 PM on Election Day, your ballot can still be counted for the next 3 days. That hasn't always been the case. Normally your ballots have to be in by 8 PM on Election Day, but right now the U.S.—

the—

I'm sorry, the Pennsylvania Supreme Court said if you get your ballot postmarked by 8 PM on Election Day, November 3rd, then the county still have a 3 more days to receive it. Why the mail? We all know the controversy surrounding the mail, the delivery of mail, and the importance of Election Day. So just for this November, the Pennsylvania Supreme Court said Get your ballots marked, postmarked by 8 PM on Election Day. Then the counties will have 3 days to receive that ballot and count it. So Joyce, advocacy matters. Most important thing, have a plan to vote and don't wait.

Yes, you know, yeah, I always say, uh, I always say, Perry, you have the most power ever in your hands, and that's the ability to vote. And Perry, we will be having you call in on Election Day because my show is on Election Day so that I can tell people with disabilities to call in if they're having difficulty voting, you know, because of not finding an accessible poll. So we'll be talking to you a lot on that day.

Look forward to it.

Okay, thanks, Perry. Have a great day. Thank you for that news break. Sure, bye. See, we try to keep all of you up to date every week for the past 2 years. We have this, um, news break so that you have a source to go to know what is going on. So, uh, Cindy, as I told them at the beginning, you are You're a tremendous supporter of the employment of people with disabilities. I wonder if you could share with our listeners why that is. Why do you believe that's important?

Well, that one's easy because I think that employing people with disabilities, I mean, one, they're some of the most experienced and talented employees that we have. They're not only knowledgeable, but they're really innovative. And I also think that people with disabilities teach us how to not only innovate how we're working, but how we can also serve our patients with disabilities. And that's been really important to us. It's a central part of our mission. So the individuals we have hired are helping us really, I think, differentiate AHN both as an employer and a health network. And, you know, we were talking a little bit ago about how telecommuting is creating kind of the new norm for our workforce. And I, like you— I've heard you say this— think that people with disabilities who may have been previously turned down for jobs because they could only work from home are now potentially finding new opportunities. I hope that is the case. And you said in a recent news article that I read that employing people Working with people with disabilities provides another payoff. It creates self-worth and a sense of independence for new hires. You give them something they have never had, freedom. It's dignity, it's respect. Joyce, I want to tell you that that article went around to so many people within our organization. People were literally cutting that out and taping to their computers because we do feel that way. I think that Highmark's partnership with you has just opened the door for so many possibilities, and it's really been a gift to us, to be honest.

Well, thank you so much, but can't do it without a company to support you. And Cindy, you know, for other business people listening to the show across the country, do you have any advice to them if they feel they are running into obstacles with management?

I think that they should be persistent. They should be logical. They should be passionate because anybody who cares a lot about people are going to do the right things to be able to hire people with disabilities because they're not any different than anybody else. They just have challenges that other people may not have. And you know what? That's nothing new. So I think that, you know, people need to stand up for themselves and have advocates like you Joyce Bender. Having somebody like you to stand up and help people with disabilities find these really great jobs, I think, is critical. And I think your voice has really carried, I know, Western Pennsylvania for sure, but across the world, as we all know. So I think you just have to keep doing what you do, but don't be quiet about it. That's my advice.

Yeah, right, right. Tony Coelho taught me something years and years ago, former Congressman Tony Coelho. He says "Joyce Bender, when you get a chance to take the podium, speak up." And I never forgot, never forgot that he told me that. And this year, as we celebrate the 30th anniversary of the ADA, no matter where you work, you should be working to get someone hired and asking, "Why not? Why can't we?" Because you can. We got tons of, you know, this untapped labor pool of people who are grateful. That's why there's such a high attendance of people with disabilities that are given the chance to work, because without that— why I say that about you're not free in this country, you aren't. Can't buy a car, can't rent an apartment, you cannot live the American dream. And for all of you that do have employment, you should thank God every day. Every day you go to work, you should be so grateful because there are people living in poverty with disabilities. There are people even with a college degree with a good grade point average, if they have a significant disability, a burn victim from the war, a veteran with a disability, or someone that has an extremely difficult time speaking or with autism, the way they come across, or people who are blind. Have a very difficult time gaining employment, you know, mental health, epilepsy, sadly, I could go on and on, wheelchair, but I'm telling you right now, and by the way, one of the people that Cindy brought on board is a person in a wheelchair. And you know what? That makes a difference too, when people actually see a person with a disability in a company because the only way you'll change the workplace of America is when people see people with disabilities working at the company. Well, as I said earlier, Cindy, 25 years ago, Highmark helped me get started. So the CEO then was Bill Lowry, then it was John Brause, then it was Ken Maloney, then it was Bill Winkenwerder, and then for the past several years, David Holmberg. And every CEO stood behind me, every one of them. And, you know, it's as Ted Kennedy Jr. says, too bad there aren't a lot of Highmarks. But there aren't, because this is unique that it comes from the top and from all the leaders at the top. So why do you think that is? Why do you think Highmark's so different?

I, you know, I don't know the answer to that, but I do know that people The people that work in this organization have very similar personalities. And I'm not saying that so people can say, "Oh, that's really great." But I mean, that is really the truth. I was in a leadership meeting, one of David's leadership meetings just a little bit ago for like 4 hours, and I was looking around the room. There's about 12 people that report directly to him. And it's funny to look at the people because we are so similar in our personalities, how we talk, and I think how we interact with people and how we treat I think that's critically important. I mean, first of all, you have to care. You have to care how other people are treated, and is it important? Is it important to the people that are working around you? Is it important for the people that you're talking about? And I think that you're lucky, we're lucky, that Highmark has been led by people who feel like that and treat people like that. So I don't know, there's no magic answer other than I feel like that, and I know that David does for sure, because we talk about it a lot. We talk about you a lot and about how you've helped our companies really grow in this area and really be more informed. So, you know, I mean, really, the thanks goes to you and all the work that you've done with your group behind this.

Well, thank you, but you know, you always need a partner. You're right what you said, you know that? The leaders, the culture, very similar because they've— You know, you've been able to engender this, I believe, because of bringing in similar people. That story you told about David telling you, "Don't worry about the cost." Right. Over 3 years ago, I meet with him, and one of the things he told me, you know, he said, "I don't want managers, I want leaders." And the second thing he said to me is, when it comes down to, making a financial decision, the answer always is do the right thing. And there—

That's what he does every time, every time.

Every time. You gave us an example, you know, today, you gave us an example of what he said when you had to do all this work for COVID. And see right there, a great leader serves. And you know, and I always tell people, when you're thinking about all these things, put yourself in the other person's shoes. The patient, the employee, you know, the person out on the street that's been marginalized. Put yourself in that person's shoes and the world looks different. And here's the thing, they do do that at Highmark.

I think, I think they do too, Joyce.

Yep, they do do that at Highmark. So Cindy, what do you see as the future here for healthcare? I know you do a lot of reading and a lot of research and talk to a lot of people and you have that wonderful background from Cleveland Clinic. What do you see as the future?

You know, I could talk hours about this because I do so much research. I mean, I really do. I'm a prolific reader about what's on the horizon, probably because of my kind of upbringing at the clinic. You know, they had this thing at the clinic where you had to bring back one innovative idea a month, every physician, that you could share with your other physician colleagues to really just make people always be thinking about what's new, what can we do better. I think that for sure there's going to be a huge shift to the cloud for health data. That's because, you know, right now you have EMRs sitting out there with all these various systems that don't talk to each other, and I think that's going to go away. There's going to be going to be old school before too long, and everything's going to go up in the cloud so that regardless of where people go to be treated for care, everyone will have equal access to the medical information, and that's the way it should be. I think that artificial intelligence and machine learning is going to have a big place within healthcare and helping solve really complex health problems and helping actually supplement the workforce, because there's a lot of things that people are doing routinely, like in our labs, and in processing, sterile processing. I can name, you know, 10 different areas that really robotic help would be the way to go, I think, going forward. I think that there's a lot— when you look at technology and what's on the horizon clinically, there's just, you know, thousands of things out there that people are getting excited about. One of the— I wrote down just a few that I'm interested in. One is because my kids have asthma. They have smart inhalers that they're working on right now. Now, what are those? Those are inhalers for patients who have asthma. And I don't— if you don't really know a lot about that, that they say that up to nearly 95% of people who use inhalers don't use them properly. So what they're doing is they're making these inhalers that are Bluetooth-enabled. They're called smart inhalers. And there's a small device attached to the inhaler and it records the date and the time of the dose and whether it was correctly administered or not, and then it goes to your smartphone so you can keep track of it and control your condition. And it's showing that— the trials are showing that using this inhaler, that people use far less medicine and had more asthma-free days. So there's just, you know, everything's getting smarter and smaller and faster. And, you know, we're going to see more robotic surgery. You know, we have a lot of robotic surgery now, but there's going to be more and more. I know of 2 or 3 trials right now that they're doing that are in clinical trials. They're starting to use 3D printing a lot. It's one of the hottest technologies out there on the market right now where they're using printers to create implants and even joints that can be used during surgery. Surgery. One of the real popular things right now is 3D printed prosthetics, so that, you know, that's— people will use those versus the other modalities of care at this point. They're saying that those are giving patients a higher level of comfort and mobility than what they're using right now. So we'll see. Artificial organs, I think that they're going to use 3D printing for artificial organs. I think that the health wearables What we see right now is the tip of the iceberg, that you're going to have wearables that will monitor anything and everything that you want it to, probably more than what you need it to, to be honest with you. But, you know, generally, I would say telehealth is here to stay, and I would also say that precision medicine, that's where they make your care plan personalized to you as a patient. I think that we're going to see more and more and more of that with gene therapy and all kinds of different treatments. So if you were to ask the clinicians, that's what they would tell you, but everything that I'm reading is saying that's the direction that we're going. Then we could get into the crazy stuff like gene modification, but I don't want to go there right now. But there's just, you know, there's good things and there's bad things, and we're going to see kind of things, but it's exciting. And it's fun to be a part of this world.

Wow. Some of those things you talked about. Now, those smart inhalers, are they out or is this just a thing of the future?

I know they're in trials, so I don't know if you can actually buy those right now. I'll find out whether you can or not. I know there's a lot of write-ups about them right now. So if they're not out on the market, they will be very shortly, I'm sure.

I mean, that is just remarkable.

Yeah, it makes sense, doesn't it? Yeah, I remember telling my kids, showing them all the time how to use their— and I knew they weren't using them right, and I was right, they weren't using them right. But this will actually teach them how to do it better.

Yeah, and I know that you're right that a lot of people don't do that correctly. And I do think that— I mean, from when you were at Cleveland Clinic, I bet you think it's astonishing how fast healthcare technology has moved.

I have, yeah, I'm astonished. I am astonished. And I watch, you know, what's going on there because they put on a top— what they call Top 10 Conference, what they consider to be top 10 innovations around the world. They do that once a year. So I watch, you know, everything that's— and it's really not a lot different than what's going on around the United States. I mean, everybody is working in the same direction. And as I said before, you know, it's faster it's smaller, um, but you know, it's the thing that we got to focus on right now is getting a vaccine. That's what we need to focus on because all these things are all great and good, but we need to protect ourselves right now.

Yes. Do you think that, um, of course I don't know as much about this as you, but once something— what does it have to do before it can come out? Does it have to go through how many trials?

I'm meaning, I mean, what I'm pretty sure. I'm pretty— I'm not positive, so I'm telling you up front I'm not positive, but I think it's 3 trials that they have to go through. And then, you know, they review the results and then they'll release it. And I have no idea when that's gonna happen. I know that there's several in phase 2 trials and I know that there's at least a couple in phase 3 trials right now.

Well, it certainly takes time, but we need it sooner. Yes, we do. Impossible. We need it. We need it now. We need it tomorrow. And I just want to say to all of you, Dr. Fauci said, scientists said, you heard the social epidemiologists on my show a couple weeks ago, masks are like vaccines. You've got to wear that mask. You've got to social distance. You've got to wash your hands and you have to remain vigilant. You know, some, some of us are thinking, oh, it's not here as much. You know, we can just go out and about, but you can't just go out and about because this one doctor said, you know, when you say, hey, I can't take this anymore, I want to, you know, I just want to be out there. The coronavirus is saying, "Well, I don't care either. I'm still here." And it is still here. So please, everyone listening to the show, wear that mask, wash your hands. You know, Cindy, when I was in South Korea, uh, 5 years ago, 6 years ago, I couldn't believe how many people were wearing masks. It seems so strange to me. And I said, to my friend Richard from the State Department, what are all these people doing? And he said, oh, they're very big here on protecting each other. I said, what do you mean? What do you mean? He said, you know, if you have a cold or the flu or whatever. I said, oh, that is really interesting. Well, how about that? As soon as this started, My friend Gang Young got in touch with me and he said, "I know in America you don't like to use masks, but Joyce Bender, I don't want anything to happen to you. You need to wear a mask." I'm telling you, Japan and India, especially South Korea, I can't begin to tell you how many people I saw wearing masks. So good to be careful. So Cindy, what message do you wanna leave with our listeners today?

Okay, I worked very hard on this, so I want, I want, I want you to listen very carefully to this because I picked this out just for you. Because I want you to— well, first of all, before I moved to Pittsburgh, I had heard of Mr. Rogers, but I didn't really appreciate Mr. Rogers until I moved to Pittsburgh. But he has a quote. His quote is, he used to say that you are special and so is everyone else in this world. And every time I I hear that quote, Joyce, I want you to know, I think about you because you are always showing your kindness and compassion towards everybody. And I think about him, I think about you and his quotes, and I'm very, very grateful and thankful that I've met you.

Oh, Cindy, that is just so nice coming from someone like you. And if you've been listening to the show, this is Cindy Hundorfean, the CEO of Allegheny Health Network. Network, and just one of the best people, the best you will meet. And I just want to tell you, if you're listening and you're saying, wow, I want my friends to hear this, all you have to do, go to Apple or Spotify and subscribe to this show. Cindy Hundorfeen, you are just wonderful. We're so lucky to have you here in Pittsburgh. And we, we end every show with a quote, and today I have to tell you I'm not going to use this quote. What was that quote you just read from Mr. Rogers?

About the kindness? What is it? You give them something they never had: freedom, it's dignity, and it's respect.

Well, there you go.

That's my second one. I had 3 quotes for you. I even like that. I even like that one better.

Well, you know what? I love that quote too. I love both of them, and I love you and everyone listening to the show. I will talk to you next week with Priscilla Korentang from Kellogg's Corporation. This is Joyce Bender, America's Voice, where disability matters, at voiceamerica.com. Talk to you next week.

Voice America would like to thank you for tuning in. Please join us next Tuesday at 11 AM Pacific time and 2 PM Eastern time for another installment of Disability Matters right here on the Voice America variety channel.

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