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Newsday: Rapid Innovation, Safe AI, and the Chief Velocity Officer with This Week Health

I'm Bill Russell, creator of this week Health, where our mission is to transform healthcare one connection at a time. Welcome to Newsday, breaking Down the Health it headlines that matter most. Let's jump into the news.

Bill Russell: All right. It's Newsday, and today I'm joined by the crew. Um, I, we should come up with our, our name, like all these do shows have like a name.

It's like,

Drex DeFord | This Week Health: Hmm.

Bill Russell: what, what's our, anyway, the crew. No, that, that, that's already taken. We'll find something else. Sarah Richardson Drex DeFord. Great to be with y'all to talk about what's going on in health. It obviously, the, the thing that's happening, uh, this week is everybody's. Gathering at Chime in, uh, or what, what's it, it's not called Chime, it's called Vive.

I, the, I wanna talk to you guys about a couple things. There was a. Uh, I wanna talk to you about the article and the, uh, the safety playbook that I put out. 'cause I got a ton of response on that. Uh, I also wanna talk to you about this, uh, ci TO trend that I am starting to, uh, uncover. Um, and I think it marks, I, I don't, maybe not the CIOT uh, CITO trend that I wanna discuss, but I, I do wanna discuss, uh.

Why it's happening and what we're seeing. Are we seeing a bifurcation of the role again? Is this the old CIDO uh, conversation that's coming up again? Is this the, uh, you know, we're gonna let, uh, CIO just handle the day-to-day run? Of the system and we need somebody who's really plugged into the organization.

And I, I think we're seeing different roles sort of pop up. And I don't know if this is, uh, an AI kind of thing or if this is a business transformation thing. And I'm, I'm wondering what this means for the CIO. In terms of, you know, are, are they more business related? Are they more technical? Where, where, where do you guys see this thing going?

As everyone gathers in beautiful Los Angeles, if that's what we can call it. Sorry, I know that you're stomping grounds, sir.

Drex DeFord | This Week Health: Mm-hmm.

Sarah Richardson: They're all, they're gonna come together just like this and filter into the rest of the org That needs to have amazing governance

Bill Russell: But you still have the day-to-day, you still have App rat. You still have, oh man, are we gonna run on Citrix? Are we not gonna run on Citrix? Uh, what are we doing about the VMware thing? What are we doing about? So you need to know infrastructure and operations. Plus you need to know operations, like just flat out healthcare operations.

Uh, so. I, I, maybe this is why the role's being split. It's just so overwhelming as a single role. But drex, we'll let you go first. You and

Bill Russell: So are you saying where, where technology meets the market, like what the services that you're offering or the product that you're offering? That's where the CTO lives. They're looking at technologies intersection with. The things you're doing and saying, Hey, the business will look a little different.

Drex DeFord | This Week Health: yeah.

Bill Russell: great example of that this week, this week is the access program.

That's what A CTO would look at and go, Hey, wait a minute. This wasn't, this wasn't designed for us to keep doing what we're doing 'cause it's well below what we should get paid for this kind of work. This was designed for a technology solution to come in here and a remote program to come in here. It's enough money for like, well not these players, but it's enough money for an Apple to get into it.

But it's not enough money for a healthcare system to, to continue its fee for service type model it. So, okay. So the CTO is as at that intersection. But the CIO is, Hey, just make sure that Epic keeps running. Make sure that those, the users of our systems internally are happy, essentially. Is that what you're.

I mean, this is all sort of a theoretical conversation, but manufacturing, those executive vice presidents of those p and ls are held like. Radically accountable for the p and l, like how it works and how it runs and driving change in that p and l so that they create the product that people wanna buy.

And so this. All of this feels a little strange in healthcare. I don't know that we, part of our problem might be that we don't hold our leaders as accountable as a manufacturing organization holds their leaders accountable. Um, we have a lot of people with a. 30, 40 year pins and they've been around forever.

And I think in manufacturing you find a lot of folks who, like, if you didn't hit your numbers this quarter, if you're not hitting your goals for this year, there is a movement that happens and we're just not

Drex DeFord | This Week Health: and maybe we shouldn't be.

Bill Russell: I don't know. We, we, we only had two retirements the whole time I was at St. Joe's, so it's not like we, we didn't have 30 year people in, in the IT department. But I'm curious, uh uh, Sarah, what are your thoughts? So.

And that's how you reinvent yourself from, you know, operator to an architect of intelligent ecosystems. I mean, and it's all very possible because you've got. The need for A CTO for the technical aspect of perhaps what you're doing, depending on the size of your organization, but as a CIO, you own now the AI frameworks across the continuum.

You own the enterprise automation architecture and you really risk, I think, political pushback from people feeling like their control has moved over truly to the technology. But that technologist is a business operator who knows how to bring all these pieces together.

I came down on the, on the side of we shouldn't have this. Um, however, I, I'm not sure where I, where I fall today, here as a CEO. What I would be looking at you and saying is how can we move faster? Like, how can we. Adapt to these things. How can we as an organization be more nimble? Now I understand when I'm saying that about healthcare, I'm talking about instead of an 18 wheeler, I want like a 14 wheeler.

You know? I just wanna be able to be a little more nimble. Uh,

Drex DeFord | This Week Health: Yeah.

How do we optimize our, the schedules of our, uh, physicians better? And by the way, I don't think that the projects matter. I think the health systems are really good at identifying the best things they wanna solve. I just think we only solve three of 'em at a time or five of 'em at a time, and there are things we need to solve.

That's like the, the, the, the backlog is out the door. I. And they're all good. They're all gonna contribute a half percent, 1%. It's going to, uh, you know, uh, it's going to improve our, our physician satisfaction scores. They're, they're just out the door. And I, I don't even think it's, the CEO's the only one who's saying this.

I think it's the entire organization's like, look, I go home and I work with these AI tools. Uh, by the way, we've had this for, for decades, right? I go home and I have cloud computing, and I can,

Drex DeFord | This Week Health: Yeah,

Bill Russell: I could store this image here and

Drex DeFord | This Week Health: that.

Bill Russell: share it and whatever, but now with ai, people are going home and they're going, oh my gosh, I can, like, I can do amazing things with this ai.

Drex DeFord | This Week Health: this is like computer chips, right? And almost like we need more parallel processing capability, right? Instead of like, maybe now we can do four threads at a time, or we can do 20 threads at a time. We need like the, the ability to do. Parallel processing in a in a ma because a lot of those things that get deprioritized, get pre deprioritized.

Even though you look at that project and you say, that kind of is a no brainer, we absolutely should do that. We just don't have the capacity to pull it off.

Bill Russell: it, Sarah, Sarah wants to go in the direction of, Sarah wants to go in the direction of the citizen programmer, which I, by the way, I don't disagree with. But, uh, all of a sudden we're looking at departments for years that we've said, Hey, come through it. You know, we, we, we govern all things technology.

Drex DeFord | This Week Health: The

Bill Russell: Did you?

Drex DeFord | This Week Health: is changing

Bill Russell: Yeah. You guys, you guys lived through that, right?

We found access databases all over the place.

Sarah Richardson: Yes, they were in people's boxes under their, their desks, and they had, you know, was remote in from their houses at night and they were the, the secret connection. But it's not the enemy. I mean, this is a signal of what's actually happening. So let's just be thoughtful about it.

Let's just say, okay, a 2, 2, 9 health systems part of our HCSP business case, citizen developers for us in our, in our health system, they're frustrated with backlogs. They want autonomy and they wanna be innovative. So instead of shutting it down, we're gonna provide them sandbox environments, we're gonna govern the APIs. We're gonna have a really lightweight intake, pro intake process. And what else? I think we would do safe standards, have guardrails and create balance.

Drex DeFord | This Week Health: if

Sarah Richardson: Yeah.

Somebody

Bill Russell: Well,

Drex DeFord | This Week Health: certainly try it out. We'd love to do a podcast with you if you go down this road,

Bill Russell: well, physician builders going in a, a new direction as well. So I saw the Epic, um, uh, winter. Cool things, winter, cool things, cool, whatever. I think that is what it's called, actually, the winter cool things. I apologize. I was never an epic, uh, client. So I, I was not inundated with the, uh, with the thing, with the,

Drex DeFord | This Week Health: lingo.

Bill Russell: the lingo.

But it's, it's governed, this is what Sarah's saying, right? So it's, and this is exactly the direction they're going. They're going, Hey, it's governed, it's monitored. You can, uh, you know, adjust it as, as you need, but you could, you, you know, if it's making a mistake, and that's, um, you know, that's, that's the, that's gold right there.

It's like we, the, um, the playbook I, I shared this past week, this safety playbook, which AI generated in less than five minutes has, has a quote in it. Um, healthcare AI won't be judged by how often it's right. But how well it protects patients when it's not right. And that's what governance is about.

Drex DeFord | This Week Health: It does not drive a catastrophic failure, right? You can, you can make a mistake, but it can only be this big, you limit the blast radius, whatever the term is.

Bill Russell: So, so that's the direction Epic's going. It's the direction ServiceNow's going. It's a direction. You know, I, I don't, I don't know Workday well enough, uh, what their strategy is right now, but it's probably the direction that all of those platform players are going. You know, that Microsoft already has that mechanism that they're, they're putting out there.

Um, but how far do we take this? Because. Uh, you know, they could fire up Claude code and, and really start developing their own stuff.

Sarah Richardson: So if you came to me on a Monday and said, Hey. We're getting, we're being asked for this, and three of us are sitting around in our, you know, IT conference room. We're gonna ensure that, uh, we have AI marketplaces or like an approved catalog. We have our own orchard internally That people understand clinical IT and compliance concerns.

And we can say that it's ai, but this is constant intelligence literacy because you still have to be technically fluent in ai. You still have to know operations. You still have to have financial literacy, you have to have governance still. your forefront, and I'm gonna throw the piece in. This is why I'd be the intelligence officer.

How is this affecting humans from a cultural, emotional, a psyche perspective? And if you don't know how to do that as a leader, then maybe that's some of the differentiation or appropriate bifurcation of a role like that, because someone is gonna be the code. Sky or girl and somebody else still has to translate that for human beings.

Bill Russell: I think I said this to you guys before, I mean we, we've now taken a product manager and. Made, made them a developer and we've now taken our graphic designer and made him a developer with Claude Code. And the reason is because I've been developing for Claude with Claude Code for the last six months and I, I sat back and was honest with myself and I said, I haven't edited the code once.

I haven't written a single line of code.

Drex DeFord | This Week Health: no code

Sarah Richardson: I know.

Drex DeFord | This Week Health: Yeah.

Bill Russell: It was, it was, it was no code. And I'm just describing it and, and every day I go in there and I just say something like, Hey, you know, this feed, I'd like to be able to blah, blah, blah, do this. And then I hit send and it, it creates it. Well, if I could do that with a graphic designer and a product manager, first of all, I should be able to do that with anybody in it, period.

Wrong word, create the right mechanisms for monitoring, for, for, for all the, the governance, as much transparency into what the tools are doing as possible. Um.

Bill Russell: Do I have a way of knowing, uh, finding all the AI agents that are on my network? Did we talk about this already? I think we have,

Drex DeFord | This Week Health: are some, there are some tools out there now that you can use to, uh, it, it, they,

Bill Russell: and it looks at patterns and it says, Hey.

Drex DeFord | This Week Health: now. Yeah. To be able to, to be

Sarah Richardson: Yeah.

Bill Russell: This is, this is gonna be really interesting 'cause I, I, I'm gonna want my CIO to move much faster and, and the hackathon thing makes a lot of sense to me. Love to have it run these hackathons around the organization. I think the CIO is gonna be required to create focus on those things that can have the most impact.

You know, if, if there is a way for them to, uh, impact the amount of, uh, terminal denials, if there's a way for them to impact the, the things that we know are big levers. That's the stuff I'm looking at, the CIO going look. There's gotta be a way to do this. There's gotta be a way to get in front of this.

Drex DeFord | This Week Health: rich

Bill Russell: Yeah. Yeah. Make it exactly.

Drex DeFord | This Week Health: they decided to back outta that and make themselves rich.

Bill Russell: Yeah.

Sarah Richardson: you covered it yesterday in two minute drill, like, yeah, I love that. Hoodies versus blazer. And the key is these are the things that have to be true for an organization for you to go look at your 50 fun AI companies out there on a show floor when you realize you could probably do most of that yourself.

Now, I mean, if I was, if I was show floor, I'm gonna go look to see what do I think is cool, then I'm gonna come back and say, how do we do that ourselves?

Drex DeFord | This Week Health: Show me the map. There's some great folks, I mean, I, I don't want to call out his name, but we all, we all know a CIO, who's really great at talking to partners, seeing what they do and how they do it, and then reverse engineering it and building it himself

Sarah Richardson: Yes,

Drex DeFord | This Week Health: So

Bill Russell: Yeah, don't, don't say his name. You're gonna get him in trouble. That's.

Sarah Richardson: but we would do the same.

Drex DeFord | This Week Health: day, I think.

And this, uh, this woman on there who's an entrepreneur has five Mac Minis on our, on our desk and she's running all this other stuff and she's creating all this software and she goes, I will never buy software again. I, I, I, like, I don't, I, I have no idea why people are buying software. I'd like you just tell me, tell me what you want it to do.

And for example, she was, she was creating this homeschooling thing for people, and she goes, one of the biggest problems, they go out to, to YouTube and these kids get stuck in the YouTube algorithm and they're looking at stuff that they shouldn't look at. She goes, so I just, you know, I created, I just talked to.

And she goes, you know, that was, I, I told her what to do one night, and I woke up the next morning and there it was. And she, she's showing it and I'm going. That's the future of software. Well, if that's the future of software, what's the future of it? Roles? Our, our role used to be buy, manage, deploy. Um, you know, it's, it's, I that's.

And then four weeks later we're like. I don't know. That's actually a pretty amazing idea. It's not because we're dumb. It's that there's this information four weeks ago and there's this information now. And so if you're a health system, I think you've gotta think about super hyperdynamic ability to change.

Bill Russell: Sarah, you brought up the, the people dynamic of this. Thank you for doing that, by the way. 'cause Drex and I, you know, we tend to, to stay away from that and, but I think we need to, I have never in my career, I, I'm the guy who likes to run into a burning building and I, most of the, most of the turnarounds I've done, I, I actually enjoy it.

Drex DeFord | This Week Health: like every day is a turnaround. Every day you're doing a turnaround 'cause because of the amount of change that's happening in the industry and in the market. And with ai, you're kind of

Bill Russell: I, I can't get comfortable. Usually you had like, you know, something happened and you had six months, you had a couple of weeks to really get your arms around it, and then you could live with it for six months. That window doesn't exist anymore. I'm, I am worried about. Uh, how people are going to, um, I don't know, cope with the amount of change that's coming at them.

And, you know, I guess we could bury our head in the sand and say, well, you know, the world hasn't changed. But it feels to me like it's changing every day.

Drex DeFord | This Week Health: Amazing.

Bill Russell: Help us and maybe bring us home. 'cause Landon's not gonna wanna listen to us for forever. He's gotta edit this thing.

now.

Bill Russell: that's a great, analogy too. 'cause it's like the, when the pandemic hit all, it was like all of a sudden all at once, it's like, go home, stay home. And, but we were learning something new every day. It's like, oh, wipe down your boxes from Amazon. Oh, stop wiping down your boxes from Amazon.

Oh, do this. No, don't do this. Oh, this is good. It was almost, uh, would you say it was about a year before we were like, okay. Not that we knew everything, but where it's like, there's a new norm. It sort of looks like this.

Sarah Richardson: gonna die by living your day-to-day life.

Bill Russell: Right? Right. Maybe a year was too long. Maybe it was six months, but it, it felt like a year.

Sarah Richardson: that psyche of like, I might physically die to now, I may be like socially irrelevant. That's a big burden. Not everyone. Think of how many people you know that haven't actually recovered from the pandemic impact to their lives.

Drex DeFord | This Week Health: We talk about leaders in isolation all the time, and that's definitely a, a, a big part of this. I mean, people, people feel isolated for a lot of reason. The pandemic caused people to feel isolated, but this also creates this world that we live in right now with AI and everything else that's going on in the industry definitely has a tendency to cause people to feel isolated.

Like, I'm so busy working, I don't have time to. Check in with anybody else. I'm, I'm buried all

Bill Russell: I feel like the kid who's gone from the eight crayon crayon box to the, you know, 128 crayon crayon box, like you can make anything you've ever wanted to make with software,

Drex DeFord | This Week Health: Yeah.

Bill Russell: go ahead and do it. And I wake up every morning going, uh, wow. I could, I could literally make anything with software I. Look for these APIs, connect this thing, do this thing.

So certain people are gonna have to have, uh, significant guardrails. But I like that in terms of, you know, it could make this much progress a year, but if all of a sudden you have a group of people that has the ability to do things now all of a sudden, yeah. I mean, it's like, it, it gets,

Sarah Richardson: our

our

listeners

to be clear, like I'm not saying the CIO role doesn't exist anymore. Really It's amplifying the need for someone who understands how to be more than a gatekeeper. Like you're the architect of safe velocity for human beings and technology, and that

takes a lot of like introspection.

Bill Russell: Architect of safe velocity Landon that's gold. Like make sure you pull that out.

Bill Russell: Architect of safe velocity. That is the, uh, that is the, theme right there. Uh, hey, I appreciate,

Sarah Richardson: stuff.

Bill Russell: appreciate being in it with you guys, keeping me sane as we, uh, try to figure all this stuff out, uh, together and, and figure it out for the community. Uh, it's, uh, these, these are gonna be some, uh, interesting couple of years.

Um, and we're not even talking about, you know, uh, Claude, uh, uh, not Opus 4.6, uh, anyway, I'm blanking on.

Sarah Richardson: by tomorrow morning. Don't worry about it.

Bill Russell: Sonnet just came out with 4.6 meaningful, uh, improvements. These releases are coming quicker and they're going from.

Drex DeFord | This Week Health: Oh, I know it's crazy.

Always great to hang out with you guys.

That's Newsday. Stay informed between episodes with our Daily Insights email. And remember, every healthcare leader needs a community they can lean on and learn from. Subscribe at this week, health.com/subscribe. Thanks for listening. That's all for now.