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Today on Unhack the News.

Christian Boucher: (Intro) is there some way that we can synergize our efforts together as a community to have these labs where we're testing out these newer technologies or these other vendors to make sure that we can build it out.

. And now, this episode of Unhack the News.

(Main) Hey everyone, I'm Drex and this is, UhHack the News the news. I think I was thinking Unhack the podcast. This is Unhack the news and I'm Drex DeFord. And over there is Christian from island. How you doing today?

Christian Boucher: Very good, sir. How are you?

Christian Boucher: Surprise me.

Drex DeFord: Well, let's start with the article from, Errol Weiss, the Chief Security Officer at Health-ISAC, and there was a, this sort of interesting thing that happened a couple of months ago. There was sort of like a general non-specific warning to everyone about something bad's gonna happen at hospitals across the country, like some kind of terrorist attack or something that didn't wind up happening.

But what kind of came from that is, I think a lot of folks having that. Reaction of like, okay, well there's this notification. So it's a great opportunity for us to look at our processes and think about what we do and how resilience works and what happens if systems go offline or if people can't come to work or whatever the situation may be.

Christian Boucher: What I liked about it is it gave organizations that kind of overall thought process that maybe we don't have all these things in line yet.

And any time that anything that pops up, whether it's, industry based or very specific to healthcare, that makes them take a step back and make sure that they've got all their bases covered. I find that very interesting because oftentimes what you'll see is that. There are some gaps and I think especially coming out of the whole covid situation with, how we had to react very quickly and probably do things that were not in the best interest of security and access that you probably just forget about, you, you did something because you had to send all these people home or you had to.

Stand up these remote care facilities, or how many things have you forgotten about on that list that you've kind of now moved on getting back into operations?

Oh, we created this exception 'cause , we needed to hurry up and get this done or approve it or get it fielded or turn on this access or whatever the case may be. And then they made the exception but they never really went. Back and finish the work they intend to. They have great intention to do that.

It's just that it gets overcome by events and then you wind up with a ton of those on the list. Hopefully they're on the list. The reality is for a lot of folks, they're not on any list and they don't find them until that, landmine blows up in their face. And so, it is opportunities like this just to be able to go back and, ask some of those questions.

It's important.

We've changed the way certain groups of individuals access the data or we had. Less oversight into the governance of it because of the things we had to do. And it's the same thing. It's, how many times do I go into my workshop and I grab a tool, I stop working on it, put it down someplace, and then I get called to do something else and then I come back and I'm like, when did I put that tool right?

It's so different. It just, we're so busy and. The pressure on IT, especially in healthcare, to continue to support the organization's, desire to progress oftentimes it's those little things that kind of fall by the wayside that you sometimes just assume are happening because they are so, benign in nature.

But I, oftentimes. Those are the things that get you, going back and looking at your access policies, making sure you have MFA to those critical systems, how many network segmentations were broke because. All of a sudden now all of these users are now working from home.

And I think, that's a lot of conversations where we have, talked with customers about ways that we can help them do those things, but. Overall it's not a bad practice to have these fire drills every once in a while to be able to revisit. It's not as easy given the pace of change that's going on in healthcare now.

I do think these are great opportunities for. Every organization, it just, spend, and maybe it's a task force, maybe it's engaging with your project managers to kind of go through and do some general, assessments. I'm sure that they do them on a regular basis, but it's never a bad thing when you're taking a step back and looking at everything that's transpired in the last two years to make sure that we're still we're still taking care of the small stuff.

Have started that path as well? Maybe we can share notes and, get some of that. It's a lot easier when you have peers that are, looking at the same problems and, those relationships are truly important to, continuing to build on what, we're trying to build on.

Drex DeFord: Sort of making that transition now to the other article, kind of feathers in together here, nicely. This series of articles that Bill's written around, VMware and the transition and the challenges around VMware and the price shock and that, and all of that. That kind of goes with it.

There's a lot of collaboration and conversation around this right now too. I know you hear a lot of it 'cause you're in the field a ton and you spent a lot of time with with healthcare organizations. What are you hearing and what did you pluck out of that article that you thought was especially valuable?

private equity has kind of changed the conversation in regards to that, but it's more about that we have for so long and it gets into like almost the community conversation where, I've used this solution for so long, it works and all of a sudden I tell you about it. And so we have this huge market share of technologies that are kind of have taken over, like the, almost they're part of the technology stack in healthcare.

It's at that point where it's, it makes me feel like we need to be more inclined to looking at newer technologies and, and, and Bill kind of talks about some of the options there, but you know, it's more about understanding that being too reliant on any platform that falls outside of the core clinical side of the house can put you in a situation like this.

And there's a lot of documentation, there's a lot of peers that are involved in that. It's kind of tough because I think we need something to kick it off, and maybe it's this moving down, but for years it's always been that , you've got that hypervisor layer, then you've got your virtualization layer that just becomes your stack.

And there's never been any I don't wanna say, experimentation with other platforms.

How do we encourage that more within the healthcare ecosystem, whether it's, engaging more with the core EHR providers to show other ways that , you can deliver the same experience.

It took something like this for all of us to say, well, maybe we need to start thinking about other ways. Yeah. And pressure on, the EHR providers to help us down that path because it's not always as simple as, I'm gonna take my team and go build out a KVM environment for this specific EHR workload because it's not on the certified platform.

it's one of those things that's been there. It's works well.

Drex DeFord: you heard me saying that two minute drill all the time, but you know, stay a little paranoid. It's this idea, I think of always looking at everything in the stack, even when it works well.

It's like. It's a place where we have anchored the ship and it's perfect. It works all the time, every time. It's really good. I'm gonna build all my other strategies around the assumption that this thing is going to be my anchor point. But you gotta go back and look at those anchor points pretty regularly and say like, is that really where I should be anchored?

So we have to build to that anchor too. And it becomes really tough because then something like this happens with VMware and everyone has to sort of then. Question themselves, which causes all the third and fourth party organizations to question themselves, the EHR vendors and others. I think to think about, like, was this really a good decision?

It seemed like such a great decision. And that's the whole, that's really the whole point. I think for me, I'm, this is really about you, but I'm on a run here, so I'm gonna go with it. There's also this, we make really good decisions about where we're gonna anchor and where we're gonna focus and what technology we're gonna buy.

The world changed and the technology changed, and maybe it's time to unhook from that anchor and rehook to another place. It's hard though when everyone else is built around that same anchor. That's your point. And how do we ultimately get everyone to move that can be a tough one.

Christian Boucher: Well, and I think it's more about, there's a long history of. Not only, success, but you know, support structures, like you said. And I think, we've lived through, a giant transition in how technology has enhanced over the last 30 years. And it's true.

'cause again, you're right, like. Go back 10, 15 years ago when you made that decision, more than likely it was probably backed by data and your peers were, looking at the same stuff and you had a, it

Drex DeFord: was a cutting edge dec decision. You were on the bleeding edge of like, Hey, we were the first, when I was at Seattle Children's, we went down this road.

We were one of the first organizations, healthcare organizations of the country to virtualize and go to zero clients. And when it was a great decision, any of these decisions should not be made. So as to put you in a position where, this is my permanent decision, right?

It's kind of the same idea, like we used to buy these things and run 'em in our data center, and we had a lot of security protocols built. To stay secure with identity and exchange of data and all those kinds of things. Because of that and what happened, a lot of it happened during COVID. We went to software as a service, and so the vendors sort of changed the model to say, you're gonna pay a monthly fee and we're gonna deal this up to you and it's gonna come through a browser, and all of that.

Christian Boucher: And I think it's one of those catch 22's where you have to be nimble all the time, but you still have to be resilient and you still have to have the ability to support those scenarios when you bring 'em in place. So I think that's kind of where we are now.

It's like, Are there other technologies out there that can help support, these features that you're getting from a vendor? Yeah, absolutely. Do I have the skillset to be able to deliver those in a time that meets my requirements? Maybe, Maybe not. And then you also have, again, you mentioned those.

Third, fourth, fifth connections into that environment that you have now built. So I think, for me it's about, again, taking a step back and doing a deep dive into your architecture in general. And I hate to say like, you need to almost have that, is there such thing as a five year plan anymore?

Drex DeFord: a lot of tech debt.

Christian Boucher: There's a lot of that to be considered as well. But I think, the more we come together and we start, examining these problems, whether it's Health-ISEC or 229, or as a community at large, I think there'll be opportunities for us to come together and find different solutions.

Again, it's just another bump in the road and as far as healthcare IT is concerned just, how do we maneuver past this and make sure that we're not tying, our entire stack to a certain pillar. Because again it's one of those, it's one of those pillars of their infrastructure.

That's the best version of the program, one that can change quickly. If you can do that, you're probably in the best position.

Christian Boucher: I think there are a lot of technologies that have recently emerged and that are starting to get some traction in healthcare that will help organizations. But there's so many different aspects besides just the technology in general.

It's, technology's usually the least of the problems. People

Drex DeFord: Like the technology is usually the easy part in the grand scheme of things.

Christian Boucher: easier.

Drex DeFord: I really appreciate you being on the show today. any last words, any other interesting stuff that's that's happening that you want to tell folks about?

Christian Boucher: I would say is that there are, and I'm on the road probably three weeks outta the month on a regular basis now, but these conversations are being had by all your peers and I think, it's great to be part of them.

And I see a big push from CIOs. All the way down, through the engineering teams about understanding, what's out there now. So I think what we're seeing kind of this and maybe it took kind of. The Broadcom and cloud software groups kinda spur that in at a larger scale, but a lot of our conversations now are really about let's reimagine where we're gonna be.

Let's find that North star and work out how, we can navigate there. It's not gonna be a one process, but they're putting a lot of effort into understanding the things they need to do and the people they need to bring in and the technologies that they need to evaluate as part of that process.

Drex DeFord: thanks again for being on Unhack the News. Always good to see you Christian from Island. Hopefully I'll catch you on the road sometime soon.

Christian Boucher: Hopefully. Is it Very soon. Drex. Good to see you.

Drex DeFord: Thanks for tuning in to Unhack the News. And while this show keeps you updated on the biggest stories, we also try to provide some context and even opinions on the latest developments. And now there's another way for you to stay ahead. Subscribe to our Daily Insights email. What you'll get is expertly curated health IT news straight to your inbox, ensuring you never miss a beat.

Sign up at thisweekhealth. com slash news. I'm your host, Rex DeFord. Thanks for spending some time with me today. And that's it for Unhack the News.

As always, stay a little paranoid, and I'll see you around campus.