Newsday - Oracle Acquires Cerner, Broward Health Breach, and Cybersecurity Possibilities

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Drex DeFord: Today modern cybersecurity programs have to be built around speed and finding the bad guys fast and kicking them out fast and then sealing up the hole that they came in through. You can build taller castle walls and wider deeper moats. That's sort of an old version of cybersecurity, and it's certainly expected that you're still going to do that. But modern cybersecurity is about speed. And finding and killing off the bad guys quick.

A great way to keep up with all the things that's going on at This Week in health it is going out and following us on social [00:01:00] media If you want to know about absolutely everything we're putting out there Twitter is the place to be You can follow us at this week in hit thisweekinhit and you can follow me billrussellhit of course. And we're having great conversations happening over on LinkedIn as well. You can find us at This Week in Health IT. We are touching on the highlights of all the great stuff we're releasing. If you want to talk with me, we can connect on my personal LinkedIn as well at Bill J Russell. [00:01:30] I love having conversations with you and sharing perspectives and sometimes I even get to share your thoughts on the podcast. If you are more of a watcher than a listener, you can go over to YouTube. We post all of our shows there except Today in Health IT which is audio only of course.

And today is one of my favorite guests. He's been doing this for a couple of years, Drex DeFord with CrowdStrike. Drex how's it going?

Bill Russell: Yes we do. We do a lot of cannabis talk on this show with us. That's our primary topic. No John is, John's great. He's going to kick off our keynote show. We're trying to elevate that show. Just 52 guests this year on the keynote show.

Well lets see when you come on we start by talking about cybersecurity in some way. So there was a breach. Let me find the story here. Talk about CrowdStrike for a second here, cause you guys are a [00:03:30] sponsor and I'm excited to have CrowdStrike as a sponsor because every time I talked to a CIO now, they're talking about the great work that CrowdStrike's doing.

Give us a little, little background on yourself and what's going on to CrowdStrike?

And so we figured out how to make it work, but, but CrowdStrike is a great set of products that really do work well together. And we work really well with [00:04:30] lots of other products that you may use in your infrastructure today around cyber security. That's really kind of the power. It's easy to use.

But modern cybersecurity is about speed. And finding and killing off the bad guys quick. And that's really what CrowdStrike's all about. We've stopped breaches.

Bill Russell: Let me ask you this. What should my expectation be of speed? One of the things I talked about last week on the today show was that we need real time, right?

Drex DeFord: Yeah. In so many different ways now we have 16,000 customers, I think around the world, not all in healthcare, but 16,000 customers around the world. And literally millions of sensors, little tiny pieces of software that are deployed on millions of [00:06:00] endpoints all over the world and all of that information is pulled into the cloud. And so CrowdStrike in a lot of ways is really a big data analytics company that happens to be in the cybersecurity business. And we have of course artificial intelligence, but literal machine learning, running on top of that database, looking for lots and lots of anomalies that may be happening on any of those end points.

So a lot of the work that we've done, especially on the incident response side customers who aren't customers of CrowdStrike endpoint detection and response, or identity protection, for example, that find themselves in the middle of ransomware [00:07:00] event and are taken down and call out for help talk to their insurance company who tells them to bring CrowdStrike in.

And so you have about two hours. And so through one of our products called Falcon Complete. I feel like I'm totally doing a commercial here, but

Bill Russell: It's it's going to be relevant in a minute. By the way, for everybody who's tuning in to say, are they going to talk about the Cerner acquisition? Yes. We're going to talk about Cerner acquisition, but, but go ahead. We're going to start with a cybersecurity.

So through a product that we have called Complete, where we actually deploy our products, but we actually run them for you too. We have something called 1 10 60. And what we can do with that product is that our SOC looking at all of those feeds can see something suspicious within about a minute. And that's usually the ML identifying there's something. Within about a minute.

But realistically, what have we seen in the last two years? Ransomware's up, I don't know, 600% in healthcare. It's a ridiculous, some ridiculous number that may not be right. Don't quote me. But it's up ridiculously which means taller castle walls and wider moats aren't [00:09:30] working. You have to be able to find them and kill them quickly.

If you can. You're good. You can do this 24 7 365. You're good. But that's a real hard model for healthcare organizations to build and run on their own.

Your thinking should be there already in your network. Okay. Now, how do you defend? I'm like, and that changed everything in my [00:10:00] mind for how we do security. And that's what you're describing. The second thing is

Bill Russell: I love the fact that we get to talk about this, but with that being said, our first story, Broward health announced that an intruder had accessed its network through the office of the third party medical provider. They breached 1.3 million records. The normal things for fraud were taken. Name, date of birth, address, phone number, financial [00:11:00] bank information, social, medical record number, driver's license number, you name it. That was what was taken. The thing I found interesting about this story is they access the system on October 15th through the 19th. Four days. And generally in healthcare, we would say that's pretty good, right? I mean, they've

Drex DeFord: Found the first one in four days and not eight months.

I would assume they can get whatever they want, but four days, granted they got 1.3 million records, but that's what they can do. In three days, or three or four days, they can get 1.3 million records. And so that's why I asked you that specific question, when are we going to start reading about the breaches where the breach happened for five minutes and they lost 50 records and we're going to go, yeah, that's, [00:12:00] that's going to become the norm instead of four days and 1.3 million records.

Bill Russell: Are we layering technologies here? I mean, so, so you're just looking at the end point and finding that thing that's happening, but don't we have technologies on the network that's looking for the exfiltration and the odd movement of data.

You have to continue to do that. Absolutely. I [00:13:30] mean, I think the reasonable person expects that that's going to be the case, but you're really not going to be secure unless you're focusing your cybersecurity program now on speed. And response time.

That is generally but competition is Epic. I mean, if, if Epic wins the DOD contract and the other government contract. Anyway, if they, yeah. If they win those contracts Cerner's like a footnote in healthcare at that point. I mean, those things really between the Intermountain [00:14:30] and the two government contracts.

That kept the, stopped the bleeding, if you will, from Cerner. I mean, they're just, every time I turned around, it was this organizations moving from Cerner to Epic. So that, that was happening on an ongoing basis. As the sisters used to say no money, no mission. And if Cerner kept losing business, then yes.

Drex DeFord: If we're going to rip and replace that's the direction that they go usually.

But in moving into Cerner, they move into it in big way. What do you think Oracle's play is here? What are they looking to do with this?

Is this at least in part there's gotta be a strategy around remote hosted Cerner moving to Oracle, running on Oracle cloud. I don't know. I'm wondering if it's a multi-pronged strategy and we only see part of it unfolding right now. [00:16:30] What do you think? What do you think the challenges that they face and where they're going?

Bill Russell: Oh my gosh. The challenges are, are amazing. So the biggest challenge being they're a publicly traded company. So this whole thing is going to transpire right in front of us on a quarterly basis. We're going to, we're going to see.

Drex DeFord: Those will be interesting earning calls, right?

Your, your investors get get antsy and it gets difficult for CEOs who don't deliver numbers on a quarterly basis. And so one of the advantages that Epic has over everybody else. Epic's able to take a 50 year view as a private. And And I think it's one of the things that they've really benefited from.

Drex DeFord: I don't think it's 34 million. Sounds low.

And we're going to move this onto our books. This is healthcare revenue. Therefore we intend to retain this number of clients. We're going to grow the government business because they have these government contracts. I think one of the risks is out clauses. I'm sure the government contracts have out clauses.

They have to shore up those things. And clearly, that's also being rolled out in the public eye and it gets dinged every rollout.

Bill Russell: And maybe Oracle is looking at it, going look, Cerner had no idea what they're doing with the government.

They don't have to worry about an out clause. So yeah, they increase their government contract space. They increase their cloud space. One of Oracle's tactics, which is not not good, and I think other players do this, so I'm not pointing them out specifically, but they tend to get very creative on their licensing.

Drex DeFord: There's a club freedom coalition that's burgeoning now too. That's looking at cloud providers but mostly organizations who sell products and run them in their own cloud. And then when the client decides they want to take that product and run it in on a different cloud service that cloud provider says, yeah, cool. You can do that. But the price of the product is just the licensing of the product is just gone up by 200% or something.[00:20:00]

And so there's that I don't know. It just doesn't feel good as a client to get wrapped up into that kind of a situation. And I think a lot of folks kind of didn't even know what they were getting into. And we're starting to figure a lot of that out now and I wonder how that's going to play in the Cerner Oracle relationship too.

You have to make Cerner clients so much better with their data than Epic clients. And by the way, I think this is doable. I don't think anybody's won that the data analytics and machine learning and AI side of this. And I think that's an area where Oracle can really help Cerner.

That's another aspect. They're touting their voice and experience. Technology. I think that's only a revenue play. I don't think their voice and any of that is any better than Nuances or even gets close to [00:21:30] Nuances because healthcare is such a specific vocabulary set that you have to introduce, that I think Nuance is going to be pretty far ahead of them. So I think it's going to be a couple of years. But I think there is a play there in the experience side, if they can somehow break apart the pieces of music. And put them back together in a way that is 10, 15, 20% more effective for clinicians to interact with the EHR.

Drex DeFord: I like that. The point being things like staff shortages and the what are real problems in healthcare that that's where they focus their energy.

Bill Russell: So you'd let me take over Oracle as their CEO? I wouldn't be

Drex DeFord: No I'm not sure I'd go there.

Bill Russell: I wouldn't go there either. There are jobs I've taken in my career where I didn't really have the credentials, but I knew I could grow into it. I don't think I could grow into that one. That's a little little beyond my pay grade.

Bill Russell: Yeah, I know what I can do now. I know what I can't do. I can be an advisor to Oracle around healthcare, but that's really probably as far as I can.

Drex DeFord: If they're listening, you're looking, you're looking for that gig too.

Our economy is shifting towards a software centric model with far reaching consequences. I think this is really true. In fact, when you described CrowdStrike you didn't describe your latest chip set or it's a software data analytics company, that's getting information real time and analyzing that stuff with advanced technologies and providing that [00:24:30] information out.

And the more data you get, the smarter it gets. I think everyone's starting to realize that the battle here in healthcare is for turning the data that we have into solutions that we need better outcomes, better equity better security and those kinds of things, because we are a wash with data and not really sure we know what to do with it all the time.

I think we'll continue to kind of see that [00:25:30] model, especially around technology where you licensed software today, you may, that will convert to subscription models over time.

And so they were able to program around the different chip sets that were available as opposed to, hey, we have a supply chain issue and we couldn't get to them. And so, because they had that software capability in house, they were able to code very quickly around the limitations that maybe a GM wasn't because [00:26:30] GM relies on their third-party suppliers to build out that whole ecosystem. That,

Drex DeFord: I wonder how that looks long term, right? When it comes to then software maintenance and service and support. Because now you've put 20 different chips in your product and you have a different software package for each one of those chips. That seems like a much more onerous ... work.

It's like they've rolled out computer end points that happen to have wheels on them. And they reprogram the dashboard and change different features and and those kinds of things. So I think they understand the layers of abstraction that are necessary and the layers that need to be [00:27:30]customized in order to interact with those chip sets.

I do agree with you, obviously we want to reduce the complexity as much as possible, but the companies that are able to deal with the complexity, I mean, you're talking about a multi million, if not billion dollar opportunity for Tesla. Because they can just get cars out there when no one else can.

Bill Russell: It's interesting. One of the things I I've been looking at closely is I think in healthcare more and more, we're going to have to figure out how to develop this muscle of coding again. And yeah, we've done it. We've had middleware, we've had some people that were doing things that maybe SQL, I don't know if coding is the right word, but they were doing some sophisticated things with SQL and [00:28:30] whatnot, but I think

Drex DeFord: Modifications. Modification, modifying cots products and those kinds of things. Yeah.

Bill Russell: But I think now we're getting to the point of there's there's going to be an advantage in being able to take your digital front door and constantly massaging it to be a better experience for your end users and those kinds of things.

I'm like, all right. What's your plan after that release date? And they just look at me like, Well, it's just, it's going to work.

Bill Russell: Yeah, no, I, I agree. I don't think, I don't think healthcare CEO's are all of a sudden going to go out and hire 20 developers and have them sit in the back room.

Those represent some opportunity for health systems. Maybe we don't have to have full blown coders anymore. Maybe it's more high-end configurators who are building applications on these low-code no-code environments.

Bill Russell: Well, let me give you the last two, and I'm going to ask you to comment on the last one. One is the changing role for IT. Getting closer to the business and developing [00:31:30] products is one of their things. But the final one is the talent war goes from lukewarm to scalding hot. Talk to me about talent. How, I mean, I've been talking to a lot of CIO's, and I've, also already been on record as saying, this is the number one issue facing healthcare IT going into next year. But I'm curious, are you hearing the same thing that the, talent war is very challenging, right now?

Or vice versa. If if you're in a small place and you've got a lot of money, if you're in a rural place and you've got a lot of money, you can hire some pretty great talent now if you're able to pay for it. So the whole, like, I don't want to live in wherever Oklahoma. So I'm never going to go to work [00:32:30]for that company.

But I think those times are largely gone. You may have to go to Oklahoma once a month for a couple of days. Maybe not even during the pandemic, you may not even have to do that. So definitely the market is with the individuals, with the talent now. The companies are going to have to pay whatever they can pay. Especially like in our world, cybersecurity, there's just a massive shortage of people.

Bill Russell: All right. Let me ask you this. Conferences. We're not that far off from conference season are we, I mean, JP Morgan just went virtual attending that on Monday, Tuesday, right here from this chair.

Drex DeFord: Consumer electronics show, a bunch of people pulled out, but it's still went on.

Bill Russell: Yeah. So, what are your thoughts? I think we have Vive in early March and we have HIMSS almost immediately after that. So they're both in state of Florida where I live.

Bill Russell: It's less than eight weeks away.

Drex DeFord: Yeah. I mean, I think we're right. We're pretty close to eight weeks away. And I think a month ago we intended, two months ago, I think we were like, oh yeah, of course we're going.

Bill Russell: What's interesting is the doctor. I mean, there are still deaths because there's Omicron and they're saying that the prevalence is Omicron right now but Delta is still out there and it's still deadly. Omicron is less deadly.

They're also expecting different variants this year. So they're like this could be just a January thing potentially or depending on where you live. Like if you started spiking in January 1st, you could see at the end of January that your spike is coming down.

I'm like, that's a great question. And I went out and found out what they were. I said this, and I was actually kind of surprised at what they were Drex. It's five days. quarantine. Don't have to test to come out. But you can come out of quarantine after five days if you wear your mask for five days. I haven't talked to a doctor about that yet, but that was kind of a surprising.

Bill Russell: It's all new. And people are like, well, this is different than the last one. I'm like, it's a different variant. It's a different disease. There are years where the flu is wildly contagious and deadly and there's years where the flu is nothing. And I think we're seeing that.

Bill Russell: On this show, we rarely talk about this stuff but this is the topic that a lot of people are talking about. And there, in the context of conferences, if you were holding a conference in early March, would you be putting plans together right now for going virtual?

Or would you essentially say now we're doing it either way? Cause it's in Miami, whoever shows shows.

And so if you're smart, you're probably creating a situation where you can get as many people to attend [00:37:30] in whatever format. They prefer to be able to get the information and be able to continue to have the collaboration. And quite frankly, as a business keep the business running and keep the business alive and the attention on a conference that accommodated everyone.

So I wouldn't be betting. I wouldn't be putting all my chips on, come to Miami or don't come to Miami. If you don't come to Miami you're not going to be at the conference feels a little shortsighted.

Drex DeFord: Protocols for HIMSS, have they published?

Bill Russell: I would imagine. Yeah, it costs some money for them to stand that up. They brought in a company, a traveling nurses who do testing cost them some money, but I don't think it's exorbitant the amount of money it costs.

Drex DeFord: Still got to get there.

I mean, it was probably a great content wise and those kinds of things but there wasn't that many people there. And you're talking about a conference that went from 40,000 to maybe 8,000 onsite. That's a big blow financially. That's the second year. If you have a third year of similar performance. I would think you're more prone to say, look whatever we have to do to get people here, let's give them free tickets to Disneyworld. I don't know.

And as you made reference to Canadians earlier, they leave the conference floor and they go out for dinner and they take off their masks and they're amongst everyone else and they do whatever. And then they come back the next [00:40:00] day and they put on their mask and hopefully that all works out. We'll see. It'd be great if there was some post-testing and all this too just to kind of see how it works, but.

Drex DeFord: Omicron specifically, right. You're talking. It seems to just be amazingly transmissable.

Bill Russell: Yeah. So we're guessing just like everybody else is. I think being able to look at this in hindsight will give us a lot more information, but looking at it forward is almost a fool's errand. Trying to figure out what Miami and Orlando are going to be like.

Drex DeFord: I'm tentatively attending. Oh, we'll see. As things unfold, we'll see how it goes but. My intention to be able to

Bill Russell: That's two full weeks, you're going to be.

Bill Russell: Yeah. I will probably attend both. First of all, it's a drive. And by the way, if you don't want to fly all the way back to Seattle and then come back there, feel free to give me a call. Come over here. We'll hang out.

Bill Russell: Drex, thank you as always for coming on the show. And I look forward to potentially seeing you at some of these conferences.

Drex DeFord: Yeah, my pleasure. I'm always happy to be on. It's always a good time. We always seem to have fun doing this. And I look forward to hopefully seeing you sometime soon.

What a great discussion. If you know someone that might benefit from our channel, from these kinds of discussions, please forward them a note, perhaps your team, your staff. I know if I were [00:42:30]a CIO today, I would have every one of my team members listening to the show is conference level value. Every week of the year, they can subscribe on our website this week, health.com or wherever you listen to podcasts, apple, Google, overcast, Spotify, Stitcher, you name it. We're out there. Go ahead. Subscribe today, send a note to someone and have them subscribe as well. We want to thank our new state sponsors who are investing in our mission to develop a next generation of health leaders. Those are CrowdStrike, Proofpoint Clearsense Meditech and [00:43:00] Cedars-Sinai accelerator. Thanks for listening. That's all for now.