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[00:00:00] Today on Newsday.

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.

All right, here we are from HIMSS 2025 and it's Newsday. Yeah. I'm joined by my favorite Newsday people. I really miss doing this show together with you guys. I want to start with the conference itself. Yeah. I, there are some that would have you believe that HIMSS is dead, especially in our community, that HIMSS has died.

I was just in the AI, this isn't even, the thing hasn't even kicked off yet. It's just the opening. Pre conference thing. I AI thing. There's over a thousand people in that room [00:01:00] so it's maybe it's different people than we usually see at conferences, but Dead is not a word. I would use well, not just only in the AI Rooms, but in the exec summit that's over at Caesars and then I was upstairs in the Cyber group too, and I don't know how many people are in there, but there's hundreds of people in there, too I don't It's dead by any stretch of the imagination.

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.

I should have started with that. Love that part. But literally, just the energy and the conversations that people are having and how happy they are to realize that the pace of healthcare, moving globally the way that it is today, we still need each other more than ever. And everybody's [00:02:00] navigating the political spectrum across the globe.

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.

But one of the things I heard from that group was the panel. First thing was that AI is an extension of the work that we're already doing. Like we're already doing. Process [00:03:00] redesign, workflow redesign. We're already doing optimization in order to make the life of our clinicians better and our physicians.

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.

Now, these might be things that we all know, we hear, but that's still a battle that's being fought in these health systems of, hey, technology can [00:04:00] be your partner in this and help your life to be better. I think is

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.

Agentic AI is much more like the tools we use today the Google Maps or whatever. Because if there's a breakdown or a slowdown, it gives you an alternate route. It gets you to where you want to be. It's all about the destination. It's all about the outcome that you want, not necessarily about just [00:05:00] automating the process.

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.

After you'd retired your flashlight in the dark with MapQuest. But how fast that became then part of your car, then part of your phone. So I don't know anybody who has a stand alone garment that you're having to update. The [00:06:00] firmware and software have to download, like plugging it back into your computer regularly.

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.

and different payer mixes. The ability to avoid burnout for your staff across the continuum. But also realize that you have to consolidate that portfolio in a way that is complimentary with the least amount of burden on the technologists and the clinicians because everything requires maintenance. So all those integration layers and the conversations we're having with our partners about the [00:07:00] ability to say not only can we deliver technology for you that is going to self monitor and self heal when there's a problem It's also going to give you a chance to spend more time with each other in a way that is more accretive to Just being behind your computer screen all the time in any way shape or form.

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

they want 10 percent more productivity, [00:08:00] right? The health system, there's also the other challenge that we hear regularly about governance and the sort of inability of a lot of health system leaders to do a great job in prioritizing things and saying no to a lot of things. A lot of the governance processes today in health systems are still very much People just come up and ask for things, like they, they're just putting in big service desk tickets as projects, essentially.

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 [00:09:00] yeah. There's a little bit of that AI versus AI feeling in our world right now. I think the, the cyber security vendors, the cyber security partners are doing a really great job of integrating AI into the stuff that they're doing, which makes it faster to be able to find incidents that are happening and stop them so that for the front line user, it's like nothing ever happened.

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, [00:10:00] individually, yeah.

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.

We already get fake outreach from him in our [00:11:00] mail now. Yeah. Yeah, it's not Bill. What is super fascinating, and I just interviewed Gary Chan from SSM. He was at one of our recent events and He is very specific about the gamification of the teaching of security protocols Why as a mentalist he gets hired all over the country because when you gamify people's learning especially the social engineering aspect which he is masterful at social engineering.

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.

And it is 100 percent a place. I check certain things every day just to make sure they're where they're supposed to be in my personal life because people can compromise so much of [00:12:00] who you are

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.

And I'm pretty fixated on the telemedicine changes that are going to [00:13:00] hit us April 1st. Who's still using telemedicine? Is

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.

Their role, behavioral health goes into effect in 2026 instead, so they have more time to think about the creativity to make sure they're still serving patients. It just has reimbursement models and utilization factors. There's gonna be times when it's still the right thing to do, especially if you have underserved populations in areas that are hard to get to, and you may just either eat that cost or think about a way to incorporate other aspects of the visit into it so you can at least, be net zero on some of it.

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.

I think for patients and families, [00:14:00] too, If it turns out we don't reimburse for telemedicine, there's a lot of patients and families that just won't get care because they won't be able to

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.

They're training these LLMs very specifically. And I don't think we're at that point yet, but look at this pace, project out like a month but at least three years, project out [00:15:00] three years. And now all of a sudden I'm getting care from Cedars Sinai, but I live in Florida because I believe Cedars Sinai has the best practice around something, but I'm getting it through essentially a chatbot, a conversation I'm having with an AI agent.

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.

You're getting a fixed fee for that patient. It's the patient being healthy that you're basically banking on. So therefore, if you want to provide that in your health system because you're already getting paid to take care of them, [00:16:00] how you do that is going to be completely up to you.

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.

I spend a bunch of time focusing on today, a bunch of time focusing on the next six months. [00:17:00] And then my three to five year mind just goes nuts. I'd be creating our persona for our health system, Sarah or Drex, that essentially becomes, alright, when we get these models together, you're going to be like, hey Drex, help me to be healthier, hey Sarah I literally yesterday took a picture of the menu and put it up to Claude and said, what's the healthiest option on here, and I came back and,

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.

And then why would you necessarily go through either your insurer or even your provider? Not that you couldn't, yet if you have a personalized AI agent or bot, [00:18:00] one that's doing your, Grocery shopping, your travel, everything else.

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.

If you think about five years down the road, too, do you think that there's going to be we went through this cycle a few years ago of personal health records, and it just wasn't, good [00:19:00] idea, but the timing wasn't right, and there were a lot of interfaces that had to be built, and patients would have had to have done things to keep the personal health record up to date.

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

about this. When we're not together, and [00:20:00] I cannot wait to just go and explore at the floor. The one thing I've always loved about HIMSS is that it's, yes, it's big and it's spread out and it's hard to find things.

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.

I move enough, I travel enough, I just want to be healthy, and [00:21:00] so I get my care wherever I need it.

Yeah, absolutely.

What do

I usually say? That's all for now.

Thanks for listening. That's all for now.

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