March 10, 2025: Our three former CIOs Sarah Richardson, Drex DeFord, and Bill Russell discuss the news from the floor of HIMSS 2025 in Vegas. What's the difference between robotic process automation and emerging agentic AI systems that adapt to changing conditions? As cybersecurity threats evolve with AI assistance, how can health systems make security training engaging rather than tedious? The conversation shifts to concerns about upcoming telemedicine reimbursement changes and their potential impact on vulnerable populations. Looking three to five years ahead, what happens when AI assistants begin supporting patients in their daily health decisions? Join as Sarah, Drex, and Bill contemplate a future where personalized health agents might fundamentally reshape where and how patients receive care.
Key Points:
Donate: Alex’s Lemonade Stand: Foundation for Childhood Cancer
This transcription is provided by artificial intelligence. We believe in technology but understand that even the smartest robots can sometimes get speech recognition wrong.
[:the same way we're talking about a I coming alongside the clinician and helping them to be better.
I think there's an opportunity for AI to come alongside every patient and help them to be better and engage with them in their health. My name is Bill Russell. I'm a former CIO for a 16 hospital system and creator of This Week Health. where we are dedicated to transforming healthcare, one connection at a time. Newstay discusses the breaking news in healthcare with industry experts
Now, let's jump right in.
right, here we are from HIMSS:thousand people in that room [:The international presence is still what to me is so engaging because this is where people come from around the world to share ideas. And you're seeing it just from accents on the floor to the name badges to the conversations to the amount of activity over the last couple of days. Because we came in early to host the golf tournament, which we raised over 37, 000 for yesterday.
e than ever. And everybody's [:So this is a place where you can still talk about how you're solving problems, regardless of who's in charge.
It is really interesting to to these AI rooms or the cyber, set up and politics are not the things that are talked about in there. It's like everybody's just trying to figure out how to make healthcare better.
And I like it because politics are like pushed to the back of the issue. It's not the difference that we have in politics, it's what can we do together as companies or as people make healthcare better for patients and families.
I'm going to let each of you pick a story.
I'm going to start with the AI one because I did pop my head into that room. A couple of things I heard the first thing Spencer Dorn was up on the stage from University of North Carolina. One of the people I follow on social media, he's really intelligent posts on LinkedIn and I love his stuff on there.
we're already doing. Process [:We're already doing all this work. We're just we're applying technology to it. It was interesting to hear them almost downplay the hype of AI to just say we are applying it to those things. The other thing I heard, and again, from a doctor, is The thing we're trying to convince people of, and it's true, it's just absolutely true, is that AI is making healthcare more personal, not less personal.
There's a belief that when you apply technology, it makes it less personal. And the point he was making was, essentially I've never made more eye contact with a patient than I have over the last year. He goes, it's a direct result of technology. And he goes, I feel like I'm practicing medicine the way I wanted to practice medicine.
tems of, hey, technology can [:we're having conversations with folks about like the agentic AI, that whole part of were really for a while or even still, we're into the robotic process automation piece of work where we can take the workflow and automate it and make it run better and faster and more consistently by doing that.
And somebody was using the example of, rPA is MapQuest back in the day. You could print out all the instructions and you can take them with you in your car, but if for some reason today that road is shut down you don't have any other way to, take care of the problem and get to where you're going.
, not necessarily about just [:And so we continue to see, I think, with that, that stuff in both the business and clinical and research side, but it is interesting to sit down with the CMIOs on a regular basis and hear them talk about the work they're doing with Ambien and other stuff that just.
Changes their life.
What are you and Kate talking about these days, on the Today Show?
Kate and I endeavor to cover something pretty significantly different every day, so that you're getting a broad spectrum of what's happening across the continuum. But what's so fascinating, and I'll even just go back to what you were sharing about, GPS factor.
GPS wasn't released to us until the 90s. It was like this amazing government technology that we knew we had to release to the public. And you used to have your, it wasn't crummy at the time, but you had your almost analog ish garment stuck to your windshield, the giant suction cup.
Right.
you're having to update. The [:And I say all that because that's how fast we're seeing the proliferation of the technologies that are doing a few things. And this is what Kate and I talk about, optimizing your staff and your workforce, being able to do application rationalization in a way that doesn't feel like you're taking things away, that people love being able to.
handle burnout and create mentoring programs and create budgeting structures and the conversations that allow people to truly utilize technology to augment human workflows that are directly combating two or three of the biggest challenges. Budgets in any form that they're coming in, whether that's reimbursement or changes.
with our partners about the [:That's what I love about all these pieces coming together We're still trying to figure out how it doesn't feel awkward and that we're going to become obsolete in our quest to become Expert practitioners of the things that we are utilizing every day.
interesting the Every time we have a 229 project, one of the questions I ask is, do you think your budget will be bigger or smaller next year?
I've never had anyone say smaller. But what they want to do is arrest the growth rate. The growth rate with, some of the platform increases, the inflation on the platforms has been incredible. But they're like, look, we just have to keep it light. Instead of a line that goes like this, we have to get a line that's
2 percent instead of the 3 8 percent they're getting from their partners.
And
percent more productivity, [:And and they got to do the work. Are we
moving fast enough? I want to get to your cyber security. Are we moving enough into the cyber security space? I see just as our team, right? What we've been able to do with AI and how much more we're able to do and how much faster we're able to do it.
I'm thinking, okay, that's just 15 people. You talk about these cyber gangs, cyber bullies, cyber nation states applying the same stuff. Are they going to get to scale quicker than we're going to be able to get to scale and protect it?
I mean there's definitely a bit of an, Remember Mad Magazine when you were a kid and they had spy versus spy?
Oh [:But we can also tell you that on the bad guys side, there's a lot of AI use right now and they are, they are automating a lot of the work that they do just to look at, for example, internet facing everything. They have just a massive inventory that's kept up to date all the time. As soon as you slip up and do something wrong and expose something, they know they can jump on it.
And it's they're using AI very effectively too.
I remember when Deloitte came in, when I was CIO at St. Joe's, Deloitte came in and they said, Hey, we need to curtail your public facing persona. They wanted me to unfriend my family members, for starters.
Oh, [:Individually, but they also, they're like, look, They're going to be able to collect this information.
And I think about that now when we're doing interviews, I don't know if you guys have done this, but I use AI a lot in the interviews now and I'll say, okay, I'll find because it's still not good at finding all this stuff. I'll find like the last 10 interviews, my last interview with Alistair, I found like the last 10 interviews, I fed it in and I said, what's top of mind on Alistair?
What are some things that he's looking at? And that kind of stuff gave me a bunch of stuff. think about that with regard to. Spearfishing? It could become very, it's already hard, they'll know that I just got off a boat after 10 days of being on a very
specific.
And they, you could, it would be really easy then to send you a spearfishing email that looks like it comes from The boat, the yacht company saying Hey Bill, you left we think you left something on the boat of attached an image. We just want to make sure that if this is yours, we just need an address to send it to.
Click on the image, it downloads malware. But it's a thing that really could have happened to you. Yeah.
ake outreach from him in our [:You start to pick up on the things that should probably, as Drex would say, make you a little bit paranoid. And I love that because most people are going to listen to their security training and they're just going to click through it while they're doing something in the background. When you make it engaging and fun, the thing that I'm always so fascinated by, cyber security training.
And best practices is that whatever you're doing at work and you're learning is what you should also be doing at home. If not more
yeah. Yeah.
le can compromise so much of [:very quickly.
Yeah. At scale. So make it fun.
Make that learning engaging and fun because there's nothing fun about having to go clean up any of the messes that inevitably might occur. But if you're prepared for them, at least you have, we did the training, we have a protocol, here's how we're handling it. When you are an easy target, people will go after you.
When you put up, even just lock the windows and doors, they'll move on to the next house, more often than not, as I like to call it.
It's interesting, it's just another version of storytelling, right? He's come up with a really innovative, creative way of telling a story, that he wants you to learn, but he's doing it in a way, he's almost tricking you into learning it, right?
Because of the techniques that he uses. It's pretty impressive.
Pretty impressive. What what else? Anything else, top of mind, or?
I'm always fixated on policy, as especially the reimbursement. I have such a thing for equity and access and the elderly and kids and all the things that the vulnerable populations need appropriate representation.
ne changes that are going to [:that just Medicare or is
it? To my understanding today, yes. It's mostly an impact on Medicare Advantage and how it's being utilized. It does affect some of the Behavioral health and rural populations as well.
al health goes into effect in:But to me When you have to make trade offs to still do the right thing and it's going to impact your budget, it's always a bit heartbreaking. And it doesn't mean you don't wade through all of the opportunities for efficiencies. You do. The ability to meet patients where they are, to me, is always going to be something that's important for us to be paying attention to.
k for patients and families, [:leave
home and get on the bus and ride for, two hours to get to the downtown clinic and take the day off work.
They just can't afford it. So unless the reimbursement
of transportation is configured into some of these plans, which is what I'm already having conversations with CIOs about is okay, maybe transportation can actually be one of the things that gets covered so we can bring people to us versus just visiting them online.
All right, I'll take the extreme because I like taking the extreme, which is reimburse telehealth, reimburse transportation. What about reimbursing a LLM that is providing care in some way that is provided by the health system? Health system is configured. We've talked to some health systems that have created these sandboxes.
ast three years, project out [:Now does that get reimbursed?
A lot of this is, does it get reimbursed than the standard model that we have today still in a lot of health care where it's like I do a piece of work and then I get reimbursed for that piece of work? Or is it built into a contractual risk model where that works to your advantage?
If I can work with that patient using an LLM and get them healthy and keep them healthy, And that makes great sense. I would do that because that's more money in my pocket and less human FTE hours that have to go out toward that patient.
You have the right value based care model. You can put whatever form of care you want into that.
g paid to take care of them, [:think we're looking at something that Could fundamentally shift a lot of things, like who provides that, does UnitedHealthcare provide that, does Aetna provide that, does CVS?
This is just another partner in that contract arrangement, right? This is a whole new company that doesn't exist today.
And I'm looking at the way these LLMs are progressing, and I'm not a Terminator guy. Oh, my gosh, it's gonna, but they're progressing a lot faster than any technology I remember in my lifetime.
The tech is progressing. I think that thinking around how you
Build these things so that they can learn and learn from each other is progressing. But then obviously with NVIDIA and other companies who are just providing the massive raw horsepower to make them run in what feels like a real time conversation with somebody, all that's making a huge difference.
My three to five year CIO mindset, and I've shared this with you guys.
sing on the next six months. [:nothing.
Was breakfast, so
going to the chicken wing place for breakfast, it
was breakfast and there was an egg white. It chose the thing. I would probably not. It was the last thing I would have chosen. Anyway, that's what it shows. I just think the same way we're talking about a I coming alongside the clinician and helping them to be better.
I think there's an opportunity for AI to come alongside every patient and help them to be better and engage with them in their health.
ersonalized AI agent or bot, [:Why wouldn't it also be your So you think Amazon's
gonna be the big competitor?
I'm gonna, I'm, how often are we on the road? They can get me
drugs, they can get me food, they can get me They
know all
about everything that I'm doing. And I have, food
sensitivities, allergies, blah, blah, blah, welcome to fifties, I like to call it.
If, it always knows where you're gonna be, how you're gonna be, what you're gonna be looking at. It starts to tell you everything from, here's how much water you need to drink, here's what you should be eating, here's how much sleep you're gonna need. And it started to integrate our wearables into our own Spaces and all the things that we need to see and do three to five years you step on a scale And it tells you where your hot spots are anything that's happening in your body And you decide you know where you're going to get that care setting to take care of it based on Different options for reimbursement and capabilities.
I love those aspects of what it will mean to have these personalized bots helping us with our lives.
ds, and it just wasn't, good [:I wonder if the next five years
We go back probably don't
call it personal health records, but because of the agent, because of the multitude of agents that may be working together on your behalf, you may wind up with a personal health record that actually coaches you to do the bulk of
my health record might not be at the health system?
I think it could be because you're going to get care in different places, because some of your care, Maybe a significant amount of your care, especially if you're largely healthy, may come from those agents. Your agents are going to know more about what your medical record really looks like than the episodic care that you get by going to a clinic or going in the hospital for surgery or something.
This is why I miss talking to you guys. Yeah. People think we're together all the time, but We're almost never together. We don't talk
When we're not together, and [:But you go to the people that barely can afford to be here, and they have all these little startup booths and ideas. It's just the conversation.
And you're talking to the person who invented it. The
person who's doing it, real time. And you just hear their vision, their ideas, their perspectives.
And then you just keep those filed away. Like those swirls out in the yard we talked about in Colin Powell's book, where eventually these little trees are going to be sprouting up. And you're like, I remember seeing that at this point. And there's a whole bunch of great ideas that aren't going to get past even this year and this week, as an example.
But the ones that do, it's moving care back to the person versus So many years of us consolidating it into health systems. We will always be here to support health systems. We're also going to be on that journey with them to tell the stories about, I am an example of a person who doesn't have an affinity to a health system.
just want to be healthy, and [:Yeah, absolutely.
What do
I usually say? That's all for now.
Thanks for listening. That's all for now.
Thanks for listening to Newstay. There's a lot happening in our industry and while Newstay covers interesting stuff, another way to stay informed is by subscribing to our daily insights email, which delivers Expertly curated health IT news straight to your inbox. Sign up at thisweekealth. com slash news.
Thanks for listening. That's all for now