The 229 Podcast

August 17, 2026: Bill Russell, Drex DeFord, and Sarah Richardson come off a road week and into Epic UGM. Ask a shop how many agents they have deployed. They might say 50. An audit turns up 76. Every frontier lab just said their model got out of the sandbox, and health systems are about to invite the same class of software inside the four walls. Pete Marks at Wake Med cut 20 applications, then the inventory went up. Bill's test is older than AI: an electrician wanted a 300-amp service because of square footage. Square footage uses zero amps. A CIO needs enough knowledge to catch a bad answer.Key Points:00:00 Welcome into the kingdom05:54 Pete Marks cut 20. Then they went up.08:08 Every frontier model got out of the lab13:31 50 agents on paper, 76 on the audit17:30 The electrician and the 300-amp lie19:13 Enough knowledge to catch a bad answerLinkedIn: 229ProjectDonate: Alex’s Lemonade Stand: Foundation for Childhood Cancer

August 10, 2026: Bill Russell and Drex DeFord preview Epic UGM (Sarah is on a plane to Charlottesville). Bill opens with the reframe that sets the lens for the whole episode: don't mistake a single big announcement for the real pace of change — healthcare moves in months and years, not seconds. Then the preview itself: AI and Agent Factory framed around clinician experience, ambient documentation a year after the freeze, the Bridge/Epic interoperability standoff and the 3-year hedge, the entire state of Washington on Epic, pharmacy as Epic's next growth line, and the leadership exodus — including Bill's real odds on Judy Faulkner's succession at UGM.Key Points:0:00 Healthcare Doesn't Move in Seconds5:23 Sponsor: Cloudticity7:09 Epic vs the Federal Government12:43 The 3-Year Hedge20:32 Epic Leadership Exodus22:48 Judy's Exit, on Bill's TermsLinkedIn: 229ProjectDonate: Alex’s Lemonade Stand: Foundation for Childhood Cancer

August 13, 2026: CT Lin, MD, spent 30 years at UC Health, the last stretch as Chief Medical Information Officer, before stepping into his next chapter as Professor of Medicine at the University of Colorado and first-time author. His new book, “It’s Not About the Tech: From Potholes to Piglets, Real-Life Lessons in Health IT,” argues that health IT success is 80 percent people and 20 percent technology, a lesson he learned by failing loudly and often. Lin tells Sarah Richardson about the radiology order set that accidentally triggered a hospital-wide outbreak of "acromegaly," the identity crisis of losing a CMIO title after three decades, and why governing generative AI will be this era's tragedy of the commons.Key Points:01:06 Not About Tech06:10 Sharing Failures10:05 Life After CMIO15:35 AI and Governance18:34 PIGs and FarewellLinkedIn: 229ProjectDonate: Alex’s Lemonade Stand: Foundation for Childhood Cancer

August 12, 2026: Marguerite Cunningham, VP/CNIO & VP Nursing at Inova Health, and Allison Morin, Chief Nursing Informatics Officer at Symplr, join Sarah Richardson to unpack how workforce management stopped being a scheduling problem and became an executive one. Maggie shares how Inova's Smart Square rollout, born out of pandemic urgency, forced the system to build real governance around staffing instead of just automating a spreadsheet. Allison brings the national view: predictive accuracy up to 97.5 percent, contingency spend cut nearly in half, and a shift from descriptive to prescriptive workforce management. Key Points:01:22 Roles and Why It Matters06:06 Governance Before Tech13:08 Results and Future AI Staffing19:42 Advice and Closing ThoughtsLinkedIn: 229ProjectDonate: Alex’s Lemonade Stand: Foundation for Childhood Cancer

August 7, 2026: Bill Russell sits down with Eric Utzinger (Revuud) while Sarah and Drex are out. The H1 2026 Signal Index put competing priorities and not enough capacity at the top of the list for 54% of leaders — and 43% said budgets are flat or declining. On this Newsday they dig into why AI ROI still feels muddy: tools return hours, not line-item dollars, and the CFO still needs the exchange rate. Along the way: operational transformation with real proof points, growth without growing, and a hard look at who actually belongs at the strategic table — including Bill on why an outside-only CIO hire can be a mistake.Key Points:01:27 54% Competing Priorities06:03 Dollars for Capacity08:48 Tanya Townsend: Operational Transformation15:08 Growth Without Growing19:56 Mistake to Hire Me22:12 Speak Business at the TableLinkedIn: 229ProjectDonate: Alex’s Lemonade Stand: Foundation for Childhood Cancer

August 8, 2026: Darren Bullock wears two titles at once, COO and CIO of Invision Sally Jobe Radiology Imaging Associates, a multi-state radiology practice, and neither role stayed in its lane for long. Darren tells Sarah Richardson how that dual seat let him fast-track one of radiology's most overdue fixes: a breast cancer risk model that finally works for women who aren't white. Together they also get into what it took to deploy it first, how he keeps his board from chasing every AI shiny object, and what separates radiology practices that will thrive from the ones already falling behind.Key Points:01:44 Dual COO CIO Role04:02 Bias and Risk Scoring07:32 Governance and Metrics17:05 Future of RadiologyBring color and joy to a child’s day: https://augustsartists.networkforgood.com/projects/166901-everyday-giving

August 05, 2026: Robert Forbes has spent 40 years in cybersecurity, from working on MILNET before the public internet existed to running the Air Force's high-performance compute center, to leadership roles at CA, Okta, and now Field CISO at SHI. Drex DeFord sits down with Rob to unpack why healthcare's AI moment is different from every other industry's. Rob introduces the concept of "minimum viable care," explains why agentic AI breaks the traditional non-human identity model, and shares the real story of an AI agent that deleted a production database while trying to log in. A candid look at governance, cost, and risk for healthcare leaders navigating AI right now.Key Points:03:21 AI Pressures and Threats05:59 Minimum Viable Care Model09:07 AI Governance Wake-Up Call11:21 Wrap-Up and CommunityBring color and joy to a child’s day: https://augustsartists.networkforgood.com/projects/166901-everyday-givingKeep up to date on the latest in health IT:https://thisweekhealth.com/news/

August 3, 2026: Bill Russell, Drex DeFord, and Sarah Richardson are fresh off a run of academic medical center events in Chicago, and the number that kept coming up in every room was staggering: $900 million in projected revenue coming out of the healthcare system over the next three years. On this episode of Newsday, the trio unpacks what that pressure is doing to CIOs, CMIOs, and revenue cycle leaders alike, from Epic anxiety and AI idea overload to the physician who quietly found her health system hundreds of millions of dollars. It's a rare, unfiltered look inside three rooms most executives never get to sit in.Key Points:02:41 Rev Cycle Durable Value07:58 Epic Shifts and Transparency11:19 Data Foundations for AI15:55 Governance and Prioritization21:11 Executive Communication WrapLinkedIn: 229ProjectDonate: Alex’s Lemonade Stand: Foundation for Childhood Cancer

June 31, 2026: David Finn has watched health IT security evolve from a compliance checkbox to an enterprise risk conversation, and now into an AI agentic era that's rewriting the rules again. Now teaching courses and advising across the industry, he unpacks what the recent OpenAI and Hugging Face breaches really exposed, and it wasn't a technology failure. It was a governance failure. David draws on decades of building security programs, including a stint as an "accidental CIO," to explain why healthcare keeps solving the wrong problem, why third-party risk is still underestimated, and why AI agents need constant behavioral monitoring instead of one-time guardrails.Key Points:04:42 Governance Over Controls10:43 Pace Change: Get It Right16:12 Third Party Risk Reality20:34 Start With Executives22:39 AI Jobs Policies Monitoring37:56 Guardrails to Behavior MonitoringKeep up to date on the latest in health IT:https://thisweekhealth.com/news/X: This Week HealthLinkedIn: This Week HealthDonate: Alex’s Lemonade Stand: Foundation for Childhood Cancer

June 30, 2026: John Helvey, CEO of SacValley MedShare, has spent five-plus years building one of California's leading regional health information exchanges. He sits down with Sarah Richardson to unpack why national data networks still fall short: patient-matching gaps, geofencing blind spots, and the 60 to 90 seconds patients and providers spend waiting for data that should already be there. John explains how his team is turning raw interoperable data into something clinicians can actually use, why health systems need better incentives to share, and what it will take to build a true patient-centered data home.Key Points:01:44 Why Interop Is Hard09:17 Push vs Pull Data Sharing11:36 Consumer Access and Identity14:55 From Movable to Usable Data20:06 Future Vision and ClosingLinkedIn: 229ProjectDonate: Alex’s Lemonade Stand: Foundation for Childhood Cancer

July 27, 2026: Clay Maddox, Healthcare Horizon Practice Manager at CrowdStrike, to unpack a threat that's quietly reshaping healthcare security: adversary-in-the-middle attacks. These aren't your old-school man-in-the-middle exploits. Adversaries are stealing session tokens after a legitimate login, then pivoting straight into SaaS applications and browsers, no credentials needed. Clay breaks down the increasing supply chain risk and the identity problem everyone's still fighting, and what CrowdStrike's healthcare team is teaching in a free session on August 13th.Key Points:00:40 What Is Adversary in the Middle02:03 Key Takeaways Overview05:02 Who’s Speaking and Unified View06:06 Register and Closing ThanksRegister for the Defending Against AiTM Attacks in Healthcare Webinar: https://go.crowdstrike.com/2026-08-aitm-healthcare.html?utm_campaign=stop_ai_accelerated_adversaries&utm_medium=evt&utm_source=prtn&utm_language=en-usKeep up to date on the latest in health IT:https://thisweekhealth.com/news/X: This Week HealthLinkedIn: This Week HealthDonate: Alex’s Lemonade Stand: Foundation for Childhood Cancer

July 27, 2026: Bill Russell, Drex DeFord, and Sarah Richardson break down a week's worth of headlines, starting with Bill’s AI musings on the future "workhorse" models built for speed over depth. The conversation turns serious fast: healthcare doesn't own its AI platforms; it rents them, and that dependency carries real resilience risk. They dig into who's actually accountable when AI gets a clinical decision wrong, unpack the first fully autonomous ransomware attack, and revisit why CIOs keep reacting to agendas instead of setting them.Key Points:05:16 Platform First and Shadow AI13:13 Owning the Harness15:57 Mayo AI Safety Lawsuit18:33 Autonomous Ransomware AgentsLinkedIn: 229ProjectDonate: Alex’s Lemonade Stand: Foundation for Childhood Cancer

Picture this. You're the CISO at one of the world's largest healthcare companies, and Monday morning brings a call about a cybersecurity incident in a legacy diagnostics environment. Before the briefing even wraps, someone walks in with news of a second incident. Different system, different root cause, same day.Drex breaks down why that scenario isn't hypothetical, using a recent real-world healthcare giant's dual cyber battles as the wake-up call. Between sprawling app portfolios, aging infrastructure, and an expanding web of AI-powered partners, the attack surface has changed and so has the shape of a breach.So here's the question for your team this week. If two incidents hit at once, could you actually handle both?Remember, Stay a Little Paranoid

July 24, 2026: Dr. Jen McKay spent 20-plus years as an internal medicine hospitalist in rural South Dakota before becoming CMIO at a major Midwest health system, and now she's the Senior Clinical Specialist at Google for Health. Jen explains why so many AI governance efforts stall out, and it usually comes down to one missing ingredient: clinical leadership at the table from day one. She unpacks why physicians serve as the real "API" between fragmented healthcare data inputs, whether AI will ever replace doctors, and what she'd tell a CMIO whose organization is adopting AI faster than policy can keep up with.Key Points:03:16 Where Governance Fails05:12 Humans Are the API06:17 Will AI Replace Doctors?Keep up to date on the latest in health IT:https://thisweekhealth.com/news/X: This Week HealthLinkedIn: This Week HealthDonate: Alex’s Lemonade Stand: Foundation for Childhood Cancer

July 23, 2026: Liz Scott is the co-executive director of Alex's Lemonade Stand Foundation, founded by her daughter, Alex, a four-year-old cancer patient who promised to raise money for kids "like her." What started as a single lemonade stand has grown into a movement with over 15,700 community fundraisers and hundreds of research grants funded every year. Bill Russell and Sarah Richardson sit down with Liz to explore how a pure, tragic story became a national movement, what a $100 donation actually funds a decade later, and why she still hasn't burned out after 20 years of building something bigger than grief.Key Points:01:56 Alex Story Spark12:06 Super Sibs Support20:01 Research And Grants25:10 Leadership And FutureLinkedIn: 229ProjectDonate: Alex’s Lemonade Stand: Foundation for Childhood Cancer

July 22, 2026: Clay Maddux, Healthcare Horizon Practice Director at CrowdStrike, joins Drex DeFord to preview a free, live webinar on August 13th that tackles one of the fastest-growing threats in healthcare security: adversary-in-the-middle attacks on SaaS applications. Clay shares a preview of what's coming, including real cases of "payroll pirates" hijacking Workday accounts and rerouting employee paychecks, plus a live demo of browser-in-browser phishing in action. Open to the entire healthcare security community, no CrowdStrike account required. Register now and bring your team.Register for the Defending Against AiTM Attacks in Healthcare Webinar: https://go.crowdstrike.com/2026-08-aitm-healthcare.html?utm_campaign=stop_ai_accelerated_adversaries&utm_medium=evt&utm_source=prtn&utm_language=en-usKey Points:01:10 Webinar Invitation02:37 What Attendees Learn04:31 Phishing And Browser Attacks05:07 Live Demo And Token TheftKeep up to date on the latest in health IT:https://thisweekhealth.com/news/X: This Week HealthLinkedIn: This Week HealthDonate: Alex’s Lemonade Stand: Foundation for Childhood Cancer

In 2022, a furious insider leaked more than 300,000 internal messages from Conti, one of the most notorious ransomware gangs on the planet, and it read like the group chat from hell.Buried in the gossip and office politics was a message that stopped Drex cold, a gang member pushing to attack hundreds of American hospitals and laughing about who might die. But not everyone inside Conti agreed with him.What happened next in Ireland shows just how thin the line is between catastrophe and survival, and why you can never build a security program on the hope that the person attacking you has a conscience.Remember, stay a little paranoid.Linkedin: https://www.linkedin.com/company/229pDonate: Alex’s Lemonade Stand: Foundation for Childhood Cancer - https://www.alexslemonade.org/mypage/3173454

July 20, 2026: A new Nature of Medicine study claims general-purpose LLMs outperform specialized clinical AI, but is that the right benchmark to begin with? Bill and Drex are joined by Yaw Fellin, General Manager of UpToDate at Wolters Kluwer, and Matt Troup, Clinical Strategy Principal at Abridge, to break down what those benchmarks actually measure, why shadow AI is already spreading through health systems, and what "clinical grade" really means. Plus: the first-ever look at UpToDate's new drug dosing feature in Expert AI, and why automaticity bias may be the next liability crisis hiding in plain sight.Key Points:03:18 Nature Study Breakdown10:25 Shadow AI Reality Check18:37 Transparency and Provenance23:40 Human in the Loop WrapKeep up to date on the latest in health IT:https://thisweekhealth.com/news/X: This Week HealthLinkedIn: This Week HealthDonate: Alex’s Lemonade Stand: Foundation for Childhood Cancer

Sebastian Estades, Senior Account Executive for Enterprise Platforms and Devices at Google, brings 15 years of healthcare software experience to a conversation that starts with a hard question: do you actually know what AI tools your clinicians are using? Drex DeFord sits down with Sebastian to dig into where health system browser security is quietly breaking down, why shadow AI usage is the gap most organizations can't even see yet, and how enterprise browser is building a real financial case against VDI infrastructure costs.Key Points:02:30 AI Blind Spots in the Browser04:56 The Shadow AI Question06:19 Quick Start Enrollment StepsKeep up to date on the latest in health IT:https://thisweekhealth.com/news/X: This Week HealthLinkedIn: This Week HealthDonate: Alex’s Lemonade Stand: Foundation for Childhood Cancer

July 16, 2026: Dr. Everett Weiss, Medical Director, Health Informatics at Rochester Regional Health, has been a clinician, a vendor, and a health system informatics leader -- and that full arc is exactly what makes this conversation different. In this episode of Flourish, Sarah Richardson sits down with Dr. Everett to unpack why clinician burnout is a systemic problem long before it's a technology problem, what a holistic wellness program looks like when it's built by someone who's lived on every side of the equation, and what really happens when a provider looks up from a keyboard for the first time in years.Keep up to date on the latest in health IT:https://thisweekhealth.com/news/Key Points:04:01 Wellness Beyond HR08:27 Power of No10:47 AI With Purpose17:59 Closing Advice and WrapX: This Week HealthLinkedIn: This Week HealthDonate: Alex’s Lemonade Stand: Foundation for Childhood Cancer

July 15, 2026: Adam Hawkins, EVP, Healthcare and Life Sciences at Cyderes, has spent more than 20 years at the intersection of clinical operations and cybersecurity, from co-founding a clinical decision support startup in college to building Cyderes's healthcare vertical from the ground up. Drex DeFord and Adam cover what the sprint to AI actually looks like from the security side, why most health systems are building guardrails while the car is already on the freeway, and the emerging concept of "blast radius", understanding not just what's vulnerable, but what actually breaks when something goes down. The conversation ends with a clear-eyed look at the next five years: machines versus machines, and what that shift means for healthcare security leadership.Key Points:01:22 Adam’s Early Healthcare Start05:10 Lessons from Robert Hershebeck07:30 Today’s Biggest CISO Challenge09:49 Security Context and Blast Radius13:03 Machines vs Machines FutureKeep up to date on the latest in health IT:https://thisweekhealth.com/news/X: This Week HealthLinkedIn: This Week HealthDonate: Alex’s Lemonade Stand: Foundation for Childhood Cancer

Drex and Sarah join to discuss how board members are quietly using personal AI tools to review confidential health system materials, and most organizations have no policy for it. From there, the conversation gets personal. Sarah shares how she uses her AI agent as a real-time wellness coach, adjusting nutrition and habits on the fly. Drex unpacks his experience with WHOOP and asks the question every wearable user should be asking: when you clicked accept, who actually owns your data? Then the conversation shifts to Epic's Su Mi, his decision to step away, and what it reveals about identity, purpose, and the cost of never stoppingKey Points: 02:38 Secure Tools and Training06:56 Wellness Coach in Your Pocket12:02 Epic Leadership Shift17:15 Purpose and Closing ThoughtsX: This Week HealthLinkedIn: This Week HealthDonate: Alex’s Lemonade Stand: Foundation for Childhood Cancer

A threat researcher at Sysdig was picking through the logs of a recent breach when something stopped him cold. The attacker moved too fast. No pauses, no fumbles, no fatigue. Over 600 payloads fired in sequence. When one failed, it read the error and adjusted. One time, from a failed login to a working fix in thirty-one seconds. No human does that.Buried in the attacker's code were comments -- the kind a chatbot writes when it's reasoning through a problem. No person was at the keyboard. An AI agent had run the entire heist: reconnaissance, credential theft, lateral movement, persistence, and finally locking up 1,300 configurations before leaving a ransom note. Sysdig calls it Jade Puffer, and they believe it's the first ransomware attack ever run end-to-end by an AI.The entry point was a vulnerable open-source AI tool sitting on the internet with cloud credentials right behind it. Health systems are bolting AI onto every workflow right now. Every one of those tools is a new door. The skill floor for running a full ransomware operation just dropped to the cost of an agent subscription. Drex has a few questions for your next leadership meeting.Remember, Stay a Little ParanoidX: This Week Health LinkedIn: This Week Health Donate: Alex's Lemonade Stand: Foundation for Childhood Cancer

July 10, 2026: Bill Reid, Healthcare and Life Sciences Lead in the Office of the CISO at Google, has spent his career working with health system security leaders, and he keeps running into the same blind spot: healthcare is underestimating the browser as an attack surface. Drex DeFord sits down with Bill to explore why the shift from thick client infrastructure to a secure, browser-first endpoint model is no longer theoretical. It is what resilient health systems are building. From managing transient clinical staff to simplifying a fractured endpoint environment, Bill makes the case for why the browser is the future of healthcare endpoint security.Key Points:01:21 Browser Attack Surface03:39 Resilient Endpoint Posture05:40 CISO-CIO ConversationLinkedIn: 229ProjectDonate: Alex’s Lemonade Stand: Foundation for Childhood Cancer

July 6, 2026: Bill Russell, Drex DeFord, and Sarah Richardson are back from four executive summits in Napa, covering CIOs, Chief Application Officers, Chief Analytics Officers, and CNIOs. The through-line across every room? AI pressure is intense, budget cuts are real, and a clear leadership vision is nearly impossible to find. From nurses being left out of decisions they should be driving, to analytics leaders managing a shadow IT explosion, to health systems already quietly building agents for referrals and claims, this is an unfiltered read on where health IT actually stands right now.Key Points:01:05 Napa Summit Themes04:55 Nursing Wins and Workflow07:22 IT Demand and AI Vision13:20 Bright Spots and Agent BuildsLinkedIn: 229ProjectDonate: Alex’s Lemonade Stand: Foundation for Childhood Cancer

Why the Browser Is Your Health System's Biggest Security Gap | Google Fridays with Andrew RolloJuly 3, 2026: Andrew Rollo, Sales Engineer at Google, has led browser deployments for organizations with 10,000-plus endpoints, with a dedicated focus on healthcare. Drex DeFord sits down with Andrew to unpack why the browser has become the most vulnerable and most overlooked tool in a health system's security stack. They cover how identity, update cadence, and extension governance define whether a deployment succeeds or fails, what a seamless day-one rollout looks like for clinical staff, and why blocking AI tools entirely is a losing strategy. Practical, specific, and built for CIOs who need answers, not theory.Key Points:01:54 Browser Security and Updates05:25 Day One Success for Clinicians07:23 CIO Checklist Identity EHR NetworkLinkedIn: 229ProjectDonate: Alex’s Lemonade Stand: Foundation for Childhood Cancer

Tala Joubert was 19 years old, living in an apartment in East London, and by almost every measure he was a ghost. Online he went by Earth to Star, or Brad, or Austin, running an amnesic OS that wiped itself clean on shutdown and routing everything through VPNs with the kind of operational discipline most professionals never manage to sustain. Investigators believe he was a core player in Scattered Spider, the crew behind more than 120 attacks including a string of ransomware hits across US healthcare, with $89.5 million in cryptocurrency traced to wallets under his control.The investigators could see the wallets and watch the money move in real time, but they couldn't put a name or an address to the person holding the keys. Then they followed the money to dinner. Joubert pulled crypto from those same ransomware wallets to buy gift cards, used those gift cards on food delivery apps, and had the meals sent to his own apartment. Blockchain analysis walked the money from the ransomware payment straight to his front door.Stay a Little Paranoid.

Jul 2, 2026:Sarah Richardson, Lisa Johnson, and Tamara Havenhill-Jacobs spent thirteen weeks completing an MIT AI strategy course on planes, evenings, and what Tamarah calls her "AI Sundays." What they brought back wasn't hype. It was clear. In this conversation with Sarah Richardson, recorded live from a 229 CIO Summit in Napa, the two leaders get honest about what actually changed: how one built the confidence to defend AI's role to her board through a theological lens, why "can AI fix that" is the wrong first question, and the real difficulty of proving ROI on work that doesn't show up as hard dollars. A candid look at what intentional AI adoption actually requires.Key Points:00:29 Podcast Welcome From Napa01:09 MIT AI Course Takeaways08:24 Intentional AI And Governance15:47 Culture Shift And Safe Sandboxes20:29 Future Of AI In HealthcareLinkedIn: 229ProjectDonate: Alex’s Lemonade Stand: Foundation for Childhood Cancer

June 23, 2026: Jason Elrod, CISO at MultiCare, unpacks why traditional identity and access management doesn't map to AI agents, what happens when an employee leaves and their agents keep running with no one accountable, and why exploitability management is replacing vulnerability management as the right frame for security leadership. They also get into social engineering of AI models, the Harvard degree story, and what walk-up song Jason would pick for a 25,000-person keynote.Key Points:09:03 Managing Agents Like Employees15:48 Agents Getting Phished22:30 Exploitability Management Mindset29:55 Speed RoundKeep up to date on the latest in health IT:https://thisweekhealth.com/news/

June 29, 2026: Scott D'Entremont, CEO of Parlance, joins Bill Russell, Drex DeFord, and Sarah Richardson to unpack the week's most pressing health IT headlines. The panel covers Mythos, the AI model just pulled offline after social engineering exposed its guardrail vulnerabilities. Then Scott brings 30 years of conversational AI experience to a sharper conversation: AI is flooding healthcare systems with auto-generated RFPs, turning serious vendor evaluation into a demo derby. Who's liable when clinical AI gets it wrong? And is the procurement process hurting buyers as much as vendors?Key Points:04:14 Clinician ROI and Patients09:48 Liability and Governance13:34 RFPs Demo Derby19:06 Pricing Tokens Outcomes29:33 Commencement AI DebateKeep up to date on the latest in health IT:https://thisweekhealth.com/news/X: This Week HealthLinkedIn: This Week HealthDonate: Alex’s Lemonade Stand: Foundation for Childhood Cancer

In February 2024, LockBit affiliates logged into their ransomware mothership and found it had been seized by the FBI and the UK's National Crime Agency. The countdown clock ran out, and the feds answered the one question LockBit spent years protecting: who runs this place? Dmitry Khoroshev, 31, going by LockBitSupp. Over $100 million in earnings. A $10 million bounty on his head. A clean win.Except the criminal world didn't fold. It fractured. When affiliates realized the FBI had been living inside Hive and the Brits inside LockBit for months, trust collapsed across the board. Paranoid criminals don't quit, they scatter. Researchers counted 41 brand-new ransomware gangs in a single year.Remember, Stay a Little Paranoid

June 22, 2026: Bill Russell and Drex DeFord launch into Newsday fresh off city tour dinners across Atlanta, Philadelphia, Pittsburgh, and Rochester. The two dig into what's actually happening with AI on the ground: a smaller health system that vibe-coded a nurse scheduling app and made it work while bigger systems looked on skeptically, the build vs. buy debate coming back with new energy, and Anthropic's announcement that Claude now writes over 80% of its own production code. Plus: the ROI reckoning that's coming for every health system spending on AI, and a big Abridge announcement on the horizon.Key Points:02:30 Build Versus Buy AI10:55 Copilot Scale and ROI21:37 Mythos and Security25:25 Ambient AI Market MovesKeep up to date on the latest in health IT:https://thisweekhealth.com/news/X: This Week HealthLinkedIn: This Week HealthDonate: Alex’s Lemonade Stand: Foundation for Childhood Cancer

June 18, 2026: Shiv Rao, Co-founder and CEO of Abridge, has spent eight years building the company into something most people didn't see coming. Now live in 300+ health systems, touching 250 million patients and processing over 100 million clinical conversations a year. But Shiv isn't just a technologist. He still rounds at UPMC as a practicing cardiologist, and that dual lens shapes everything about how he thinks. In this conversation with Bill Russell, Shiv reframes what Abridge actually is: not an AI scribe, but computable infrastructure. The clinical conversation sits upstream of every workflow in healthcare, and what Abridge is building is the platform that proves it.Keep up to date on the latest in health IT:https://thisweekhealth.com/news/Key Points:01:41 Big Announcement Beyond Notes06:29 Unified Patient Intelligence10:52 Enterprise AI and Trust15:59 Coalition With Payers and NVIDIA35:27 So What and Closing BetsX: This Week HealthLinkedIn: This Week HealthDonate: Alex’s Lemonade Stand: Foundation for Childhood Cancer

A dormant Instagram account tied to the Obama White House started posting pro-Iranian content. No hacked password. No malware. No phishing email. Just a polite conversation with Meta's AI support agent.Researchers are calling it out plainly: AI agents are built to be helpful, and that eagerness is exactly what attackers are starting to exploit. The attack surface isn't the password anymore -- it's the agent.Health systems are deploying AI right now for scheduling, intake, and benefit verification. Has anyone on your team actually tried to socially engineer yours?Remember, Stay a Little ParanoidThanks to Cyderes for sponsoring this episode: https://thisweekhealth.com/partners/cyderes/

June 15, 2026: Bill Russell, Drex DeFord, and Sarah Richardson sit down to work through the question sitting at the top of every health system's agenda: what has AI actually done for us? Personal productivity gains are real. Meeting counts are dropping, hours are being saved, and individual leaders feel the difference. But the enterprise ROI case is proving harder to make. With Dave Lundahl's three-era framework for healthcare IT adding historical weight and the ambient listening wave cresting, the industry may be entering its accountability phase.Key Points:04:22 Governance Five Questions08:08 Cost ROI And Licenses10:04 Third Era Of Health IT17:49 Patient Companion Future23:47 Wrap Up And Next WeekKeep up to date on the latest in health IT:https://thisweekhealth.com/news/X: This Week HealthLinkedIn: This Week HealthDonate: Alex’s Lemonade Stand: Foundation for Childhood Cancer

June 10, 2026: In healthcare where downtime means lives, identity security is no longer just about who logs in. Bill Russell sits down with Peter Barker, Chief Product Officer at Ping Identity, to unpack why the agentic AI era demands a fundamental rethinking of identity. From giving AI agents first-class credentials to shifting the security boundary from login to the point of action. If your health system is deploying AI and you have not addressed non-human identity, this conversation is where to start.Keep up to date on the latest in health IT:https://thisweekhealth.com/news/Key Points:01:18 Why Agents Change Identity07:43 Runtime Identity And Authorization15:00 Healthcare Passwordless Trust20:11 CISO Playbook And Wrap UpX: This Week HealthLinkedIn: This Week HealthDonate: Alex’s Lemonade Stand: Foundation for Childhood Cancer

That UAC prompt -- the little shield asking you to approve a publisher -- is one of the most foundational trust signals in Windows security. Your tools rely on it. Your team relies on it.Two people figured out how to sell it. What they built, and which ransomware gangs bought access, has a direct line to at least one recent health system breach. Drex breaks it down.Remember, Stay a Little Paranoid

CISA -- the federal agency whose job it is to protect America's critical infrastructure -- had its own internal credentials sitting in a public GitHub repository for six months. Plain text passwords. AWS GovCloud keys. SSH access tokens. Visible to anyone on the internet with a browser.What makes this worse: the contractor who created the repository didn't slip up accidentally. They actively disabled the default GitHub protections designed to prevent exactly this from happening. And when the repository finally came down, those AWS keys stayed valid for another 48 hours before anyone thought to revoke them.Drex brings this back to the question every health system CISO should be sitting with: How many contractors have access to your most sensitive systems right now -- and if one of them made this choice six months ago, would you even know today?Remember, Stay a Little Paranoid Linkedin: https://www.linkedin.com/company/ThisWeekHealth Twitter: https://twitter.com/thisweekhealth Donate: Alex’s Lemonade Stand: Foundation for Childhood Cancer - https://www.alexslemonade.org/mypage/3173454

June 8, 2026: Bill Russell, Drex DeFord, and Sarah Richardson break down three headlines every health IT leader needs to hear. New York City Health and Hospitals suffered a breach that exposed biometric data, fingerprints, palm prints, and geotagged photo metadata through a third-party vector. Unlike passwords or Social Security numbers, that data cannot be replaced. Second, the long-anticipated HIPAA Security Rule update is overdue, and organizations that had two years to prepare are still unprepared. Lastly, Microsoft burned through its entire AI budget in five months. As AI spending spirals, the panel asks the harder question: Does every AI project reduce spend or increase revenue? If not, why is it funded?Key Points:02:31 Biometric Breach Fallout10:41 Data Retention and Hoarding12:59 HIPAA Security Rule Update21:10 AI Spend and ROI RealityKeep up to date on the latest in health IT:https://thisweekhealth.com/news/X: This Week HealthLinkedIn: This Week HealthDonate: Alex’s Lemonade Stand: Foundation for Childhood Cancer

June 5, 2026: Bree Bacon doesn't just talk about burnout; she survived it. Author, Speaker, & Elite Energy™ Coach, Bree spent years giving 110% to everything until panic attacks and her miscarriage forced her to crash. What she discovered in the aftermath became a life-saving framework that challenges everything healthcare leaders think they know about performance, capacity, and sustainable success. Elite Energy isn't just a theory; it’s tested through fertility loss, chemotherapy, and the impossible choice between career and survival.Key Points:02:54 The Reality of Burnout07:37 Bree's Personal Journey with Healthcare10:52 The Elite Energy Framework21:07 Overcoming Cancer and Embracing LifeX: This Week HealthLinkedIn: This Week HealthDonate: Alex’s Lemonade Stand: Foundation for Childhood Cancer

June 3, 2026: Adnan Iqbal, co-founder and CEO of Luma Health, joins Bill Russell for a direct conversation about one of healthcare's most stubborn problems: patient access. With 14-day average waits for a PCP appointment, 18% no-show rates, and call centers buried in fax workflows, the problems haven't changed, but the tools finally have. Adnan shares how Luma built a platform from scratch to orchestrate access, intake, financial experience, and patient engagement in one unified system, why deep EHR integration separates real solutions from the AI noise, and how health systems are seeing 50% top-line revenue growth by solving access first.Keep up to date on the latest in health IT:https://thisweekhealth.com/news/Key Points:03:59 From Waitlist to AI10:14 Omnichannel and Escalations12:35 Governance and ROI19:38 Platform Future WrapX: This Week HealthLinkedIn: This Week HealthDonate: Alex’s Lemonade Stand: Foundation for Childhood Cancer

June 2, 2026: Crystal Broj, Enterprise CDTO at MUSC, is an IT executive, Becker's 2026 Digital Officer to Know, and Top 50 Women Leaders in Healthcare honoree who has built her career on one core belief: start with the problem, not the technology. In this episode of Flourish, Sarah Richardson sits down with Crystal to explore what it really takes to lead complex change, develop talent that outlasts you, and call out AI hype for what it is. From growing a team of one to ten at MUSC, to sharing the Lotus Notes failure that shaped her career, Crystal brings candor, energy, and a rare clarity to what great leadership actually looks like in healthcare today.Keep up to date on the latest in health IT:https://thisweekhealth.com/news/Key Points:01:31 Leadership Energy and Mentorship11:37 Building Talent and Team Rhythm21:01 Vendor Partnerships and Pushback26:33 Career Growth and Final TakeawaysX: This Week HealthLinkedIn: This Week HealthDonate: Alex’s Lemonade Stand: Foundation for Childhood Cancer

In late 2025, cyber attackers slipped into New York City Health + Hospitals through a third-party vendor and stayed undetected for nearly three months. When they left, they took more than records and Social Security numbers. They took fingerprints and palm prints -- biometric data belonging to some of the most vulnerable patients in the country.You can cancel a credit card. You can get a new password. You can even navigate a stolen SSN. You cannot get new fingerprints. What walked out of that network in November is permanent.Drex uses this breach to ask a question every health system needs to answer right now: do you actually know where your biometric data lives, who can reach it, and what protections are in place? Badge readers, palm vein scanners, EHR workstations -- the collection has grown fast. The mapping hasn't kept up.Remember, Stay a Little Paranoid

June 1, 2026: Bill Russell, Drex DeFord, and Sarah Richardson bring back the highlights from three simultaneous healthcare summits in Destin, Florida, covering imaging leaders, CTOs, and children's CIOs. The conversations were connected by a few uncomfortable truths: four in ten health systems cannot measure the AI they have already deployed, most organizations have dozens of agents running on their networks without anyone knowing, and budgets are getting squeezed by rising RAM costs and what leaders are calling the AI tax. From data literacy gaps and ungoverned agents to the idea of onboarding AI like a new hire, this episode captures what healthcare's sharpest leaders are actually wrestling with right now.Key Points:00:46 Summit Takeaways Setup09:55 Agents and Governance Gaps18:18 Proving AI ROI22:31 Budgets, Vendors, and WrapKeep up to date on the latest in health IT:https://thisweekhealth.com/news/X: This Week HealthLinkedIn: This Week HealthDonate: Alex’s Lemonade Stand: Foundation for Childhood Cancer

May 29, 2026: Asim Malik, VP of Health System Partnerships at DispatchHealth, joins Sarah to explore how high-acuity care is moving beyond traditional hospital walls. From pneumonia to COPD exacerbations, discover why this isn't just about convenience; it's about solving capacity constraints, improving margins, and giving patients back control. Asim breaks down the technology infrastructure, command center requirements, and clinical buy-in needed to make these programs succeed at scale.Key Points:02:01 Challenges and Solutions in Home-Based Care06:53 Technological and Operational Requirements09:46 Overcoming Barriers and MisconceptionsKeep up to date on the latest in health IT:https://thisweekhealth.com/news/X: This Week HealthLinkedIn: This Week HealthDonate: Alex’s Lemonade Stand: Foundation for Childhood Cancer

May 25, 2026: Bill Russell, Drex DeFord, and Sarah Richardson turn the episode into an informal review of Sarah's MIT AI Strategy and Leadership course, and the insights are worth the homework. From the surprisingly perfect parallel between today's AI resistance and the original Luddites, to the counterintuitive finding that the organizations succeeding with AI are the most operationally aligned, not the most technically advanced, this conversation cuts straight to what healthcare leaders actually need to know right now. Lead with curiosity, start with clean data and aligned people, and remember that the real AI differentiator is not automation. It is velocity.Key Points:02:27 Inside the MIT AI Class08:42 Trust and Leading Through Change18:41 Operational Alignment Wins22:52 Curiosity and X Teams26:17 Courage and ClosingKeep up to date on the latest in health IT:https://thisweekhealth.com/news/X: This Week HealthLinkedIn: This Week HealthDonate: Alex’s Lemonade Stand: Foundation for Childhood Cancer

May 26, 2026: Krista Arndt, Associate CISO at St. Luke's University Health Network, and Anahi Santiago, CISO at ChristianaCare, join Drex DeFord for an unfiltered conversation about what it actually takes to lead healthcare security in 2026. From saving nearly 200 hours a month with Microsoft Security Copilot to building a team culture so strong that people rarely leave, Krista and Anahi pull back the curtain on AI adoption, mental health advocacy, and the intentional choices that separate thriving security leaders from burned-out ones.Key Points:03:27 Saving Time with Security Copilot12:15 Partners, Vendors, and AI Value15:09 Work Life Harmony and Community24:38 Lightning Round Hype Songs WrapKeep up to date on the latest in health IT:https://thisweekhealth.com/news/X: This Week HealthLinkedIn: This Week HealthDonate: Alex’s Lemonade Stand: Foundation for Childhood Cancer

May 22, 2026:  Laurie Wheeler, COO - IS&T of MultiCare Health System, is a leader whose philosophy centers on curiosity, humility, and genuine human connection. Laurie shares about her 26 years at MultiCare through listening tours, transforming employee engagement, and leading without ego. From teaching high-reliability courses to creating clinical super user groups, Laurie demonstrates how operational excellence and compassionate leadership create workplaces where people want to build careers they're proud of.=Key Points:02:18 Mentorship and Trust09:57 Healthcare and Hospitality13:00 Leadership and Humility20:15 Speed Round and Final ThoughtsX: This Week HealthLinkedIn: This Week HealthDonate: Alex’s Lemonade Stand: Foundation for Childhood Cancer

May 20, 2026: Mark Ferrari, VP of Advisory Services at Fortified Health Security, joins Drex DeFord on UnHack for a candid conversation about the threat landscape keeping healthcare security leaders up at night. From asset inventory gaps to the explosion of identity-based attacks, Mark brings a rare perspective shaped by military service, 30 years as an EMT, and deep healthcare IT experience. He pulls no punches on why healthcare keeps buying tools before defining the problem, and what it actually takes to reduce risk rather than just measure it.Keep up to date on the latest in health IT:https://thisweekhealth.com/news/Key Points:01:16 Mark Ferrari Background05:21 Hot Topics: Basics and IAM12:40 Incident Response Patient Safety14:46 EMT Mindset ClosingX: This Week HealthLinkedIn: This Week HealthDonate: Alex’s Lemonade Stand: Foundation for Childhood Cancer

Ransomware attacks don't always start with a ransomware gang. They start with someone who gets paid to find the door.Aleksey Volkov, known online as ChewbaccaCore, was an initial access broker. His job was identifying vulnerable companies, exploiting their networks, establishing a foothold, and selling that access on dark web marketplaces. Over 16 months in 2021-2022, his work enabled attacks on seven confirmed US businesses, resulting in $9M in confirmed losses and $24M in intended ransom demands. In March 2026, he was sentenced to 81 months in federal prison.For healthcare leaders, the takeaway is uncomfortable: healthcare organizations are premium listings on these dark web markets. Legacy systems, large vendor and contractor ecosystems, high-value data, massive operational disruption risk, and historically thin security investment relative to exposure all show up in the listing price.Someone may have already found a way into your network. They may be holding it. It may have already been sold. Stopping a ransomware gang when they arrive is one problem. Knowing whether someone has already been paid to find the door is a different one.Remember, Stay a Little ParanoidX: This Week HealthLinkedIn: This Week HealthDonate: Alex’s Lemonade Stand: Foundation for Childhood Cancer