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Today on Unhack the News.

(Intro) you have to consider that. Just because something works today is not going to work in two months from now and it takes diligence and it takes a lot of work, but like you said, we're all partners here

Hi, I'm Drex DeFord, a recovering healthcare CIO and long time cyber advisor and strategist for some of the world's [00:01:00] most innovative cybersecurity companies. Now I'm president of this week Health's 229 Cyber and Risk Community, and this is Unhack the News, a mostly plain English, mostly non technical show covering the latest and most important security news stories.

. And now, this episode of Unhack the News.

(Main) Hey, welcome to Unhack the News, where we try to take some time to make sense of what sometimes feels like a lot of nonsense happening in the world. And I'm joined by Christian Boucher from Island Healthcare today. Hey, Christian, welcome to the program.

Thank you, Drex. Always a pleasure to talk.

How's it going?

Very good. Very good. It was great catching up with you at VIVE last week.

Yeah. Where are you today? Where in the world is Christian today?

I'm back in Massachusetts getting ready to head to HIMSS in a couple days for HIMSS 2025.

Nice. I don't know when this will air exactly, but just in case, your booth number at HIMSS?

, [00:02:00] 748? Yes. Okay. All right. Awesome. So c. Christian and the gang from Island with IGL 748. How did I go? just see a lot of people and hang out with a lot of folks? I went by the booth. You guys. I could barely, wedge my way in there.

It was a very good event. This was the first time for Island to participate. As a sponsor. So it was very interesting. The amount of conversations we had, not just with customers, but also a lot of the partners who are very interested in what we were doing. It was a great opportunity to get in front of a lot of different people and showcase what we're building here.

And I would say that we get a lot of positive feedback of our view on how the transformation of computing and healthcare will look like in a couple years.

You were hanging out to the, with the SHI team too, so we saw you guys over there too. I was lounging on those couches quite a bit.

That was my,

they were nice. I wish we had a couple of those in our booth. 'cause my feet were a little sore after, 10 hours on your feet all day long.

Yeah. That was my rally point. Okay. Let's get to a couple of [00:03:00] articles. I love that you send me news articles ahead of recording the show, but what I really love is sometimes you send me things that aren't traditional articles, and you've done that today.

We have two things to kick off the conversation. The first one was written by Bill Russell from This Week Health, an article on LinkedIn, and he says, health care still doesn't understand the cloud. And thanks for sending that. And so I'm going to ask you right out of the gate.

What was the thing about that you thought was especially intriguing?

I think there were a couple pieces. And, historically we saw some organizations jump in full bore with cloud and intense in that scenario. And then we saw some that were a little bit more conservative and maybe only, adopted some SAS applications and moved other workloads there.

But I think the more you look into it and the maturity of a lot of these platforms, it gives organizations a lot of flexibility to look across their portfolio. What makes sense? Where are our biggest challenges in the infrastructure side? Because we always talk [00:04:00] about. The security aspect and the resiliency aspects, I think we've grown past those in most scenarios.

And you look at it as just another extension of your own infrastructure. But as we start breaking down, where it makes sense, it's, it, for me, I come from more of the. The CTO operational kind of how things are impacting my teams. We did a study, this was going back when I was still on the provider side, but how many hours a day are my engineer spending on just keeping the lights on?

And they're not spending the time actually developing solutions that improve overall operations and user experience or, cost savings. That's where I start looking at where the benefit is. And also it gets to that point where, especially in health care, a lot of monolithic solutions where you're constantly having to refresh hardware in some instances, every two to three years.

Yeah,

those are cycles being taken away. When you start adopting cloud, all of a sudden, those transitions become a lot easier for organizations. And again, you can take more focus on. You know taking care [00:05:00] of infrastructure keeping the lights on maintenance and Move your engineers back to where they bring the most value to your organization is and that's is engaging with your end users understanding all the different use cases that are being built out nursing It's a low hanging fruit because you can go across 10 different units in a hospital and see 10 different workflows, how we build solutions that solve each of their issues, not one blanket one that kind of, works for everybody, but it's not optimal.

I think we will see efficiencies, not only the cloud adoption, but in Our, overall operational initiatives to, and bleeds into second article is. But how do we de stress our clinicians? How can we make those interactions with technology, because it's everywhere now, how do we make them simpler?

And if we can take our engineering teams and work more on that, I think overall we'll see a better outcomes across the board.

Dude, I like where your head's at. There was this term that I started using originally. It's when I was the CIO at Scripps and then Seattle Children's really, we lit it up and it was called Lights on Doors Open, [00:06:00] Lido.

And it was really about the investment that you made. Not only from a dollar perspective, but the humans to do lights on doors open stuff, just keep the trains running on time. And it takes a huge amount of the budget to do Lido. And so Bill's argument here essentially is.

If you can figure out how to shift that LIDO burden to the cloud, you can take the people that are doing lights on doors open today and shift them into making life better for the clinicians and the business and the clinical, and the research operators. And yeah I love where your head's at, especially as you look into the future and what we're really going to have to do to.

Maximize the challenges that we have in the number of care providers and the amount of care that we can really provide, given the people on the front lines now,

and that's one thing that, we have been focusing more here in Ireland is understanding that [00:07:00] organizations need kind of the dexterity to be able to deliver various experiences across, several different workflows.

And spent, 25 plus years in health care, understanding how those use cases play out and how we can help curate those to make sure that when the engineers and the architects that are working with the product delivering solutions back into those clinicians hands.

They have the ability to scale to what is needed. Now, sometimes that's cloud resources, sometimes it's on prem, sometimes it's bringing in certain VDI solutions. How can you curate that experience so it's on demand for each of those use cases and at the same time make sure that the overhead for those administrators and engineers is lowered as well.

Instead of stitching together all these disparate Experience deliver that in one. , that's what I focus on a lot with our teams. I come from more of the end user side and understanding that where a lot of our engineers are security based. So we're melding of minds here, trying to figure out the best ways to do [00:08:00] those things in tandem, all at the same time, improving user experience.

Yeah, the user experience too. Just giving them a consistent user experience, whether they're on mobile or on a tablet or on their phone or, at a desktop like device, whatever it is, they don't have to spend a lot of time thinking about okay, I'm on my phone. How does this work on my phone again?

How do I get to that? That is all sort of like, just wasted time that they really should be focused on the patient and we've distracted them with technology.

Absolutely. It even bridges out into, remote workers. How are doctors interacting with the technology when they're working from home?

Or, partnered with a BPO that's doing medical coding or radiology. We've seen a big push in that recently. How do we simplify their ability to interact your applications and data as well?

Yeah, I want to move to the second article because I like this one too. This one's by David Muntz good friend from Starbridge Advisors.

We were on the chime board together once a long time [00:09:00] ago, and I really love David and I like the way that that David thinks, and he has an article, a blog, really, that is beyond the status quo. 16 transformative steps for healthcare in the digital age. This is part one. You sent it to me. There are 16 things.

There are eight of the 16 are listed in part one. Which one was your favorite? What prompted you to pick this article?

What prompted me is that, not only is my wife, a nurse, so I interact with how she interacts with technology and sometimes, just the, and of course, by nature, a lot of her friends and a lot of my friends are physicians and their struggle with adopting new technologies or delivering.

So it really comes back from that user perspective. At my point, I really enjoy. trying to, even historically work at elbows, distance with physicians trying to understand how they deliver their care. Because in reality, our job as leaders is to make that as simple as possible or make it as like as possible.

[00:10:00] We're bringing in all these, foreign barriers. back to a story early on in my days in healthcare where we were implementing a new technology and we actually had doctors that were like, if I have to do this, I'm going to leave the organization. It was that, we had, it was very traumatic for some individuals.

And I think it's progressed significantly since then, but we have to understand from their perspective. And I always try to be able to look at things from everyone's viewpoint, because really When really get down to it, their job is to take care of patients. What we're asking them to do is far beyond what they signed up to do originally.

Every single step that we can make to make their lives easier, and some it, I think we mentioned this earlier, I'm not sure if it was pre call, the investment that we're making in technology shouldn't have a negative impact on the people that we're trying to help. And that's where sometimes as engineers, we look back and we think we know how to fix this.

This is very simple. 1, 2, 3 step process, and it's easy. But when you take a step back and really [00:11:00] look at how those nurses are working on the floors, you can step across three different units on the same exact day and see nurses interacting with technology totally differently.

If it's

a ER, if it's a critical care unit, if it's an oncology unit, everyone has to be comfortable with how they're interacting with technology.

And I also feel they don't know what they don't know. Like they see the technology and they like I think I'm supposed to do it this way, but what can I possibly do with it? So those real interactive sessions having, and we had an innovation unit back at one of our hospitals where we would bring new technology, new applications, new devices out to the floors, and they signed up to be part of that process.

they were a split unit. So they had a couple of different units on the floor. So they actually had different interactions, depending upon which unit they were interacting with. So it gave us a lot of insight and we were able to really curate specific. Experiences for those clinicians.

Some of them really liked the tablet base because , it was more of a pediatric [00:12:00] unit. So we had the ability to, look at their workflows, how it made sense to them. The other group that really liked the workstation on wheels and one other one really drove to PCs in rooms on the walls, so they didn't have to worry about bouncing around the carts and all that stuff.

So it gave us a lot of insights into how different it actually is. We may think all nurses work the same. It's not even close to that. It's amazing how different you can see different. Don't get me into the doctors because they're very similar. We hadn't. Everybody wanted to do something different.

So it was very interesting. But the whole adoption of technology has to be a partnership with those groups and understanding that one size doesn't fit all just in technology, we can't assume that. One EHR operates the same as the next EHR, they're all different, and we need to look at those individually as we start engaging with those specific populations we're hoping to help.

Yeah we talked about people process technology, and I think you're right. It's really important that we don't think of people as robots. We want to have good [00:13:00] standard processes and good standard work. It takes a lot of the variation out of the practice of medicine, which can be good for the ultimate customer, who is the patient, but As you partner with your clinicians, and you talk about this all the time to our customer is the patient, our doctors and nurses and lab and rad and pharmacy.

Those are our partners to be engaged in the provision of great health care to our patients and families. We have to build tech that doesn't cause them. Pain, right? We want them to spend more time with patients. We want them to help cure patients. And so when we give them tech that causes them that kind of like distraction and challenge and pain, that's not good for our customers.

Not good for our patients and families. And that whole process of going and sitting with them and watching how they work and figuring out how to either improve the process. One of the items that, that David puts in the article is encourage [00:14:00] innovations in nominal processes.

Meaning, like one of my favorite parts of innovation was always the go look at the process before you make any more investments. Just go look at the process and see, cause sometimes. The person who's using the application might just be using it wrong. Maybe they just need a tiny bit of training that at the elbow reference that you made earlier just sitting down with them and watching them.

You can probably help them become more efficient just by being there and teaching them how to use the system better. But sometimes it also comes back to this idea of we also need to. Adjust the application or the way the applications delivered because that makes their life easier too, right?

Yeah, are we delivering the right tools at the right time for them and of course you have some disparity in understanding of the interactions, especially, you know Recently with a lot of you have a lot of travel nursing

involved. So

How do you make it repeatable enough?

At that base level so that you can on board [00:15:00] and, a seamless manner, but at the same time it's constant refinement. can remember we would have biannual kind of reviews of the technology that we were implementing to make sure it was working the way it was supposed to not that we didn't have an active.

Communication with the teams, but sometimes things like, we had a certain medication scanner that was problematic and we didn't know. Things

becomes irritant for them and they just start to live with it as part of the normal part of the process.

And you walk into a nursing station and we see a box full of them is there, what's these need to be repaired.

Oh, they just never worked properly. And we went over there and grabbed the three other versions that we have on the other units. And we're using those across all the different workstations on wheels. So you have to consider that. Just because something works today is not going to work in two months from now and it takes diligence and it takes a lot of work, but like you said, we're all partners here and I think, building that relationship early on it's great for not only I would say the patient, [00:16:00] but as clinicians start realizing that you are engaged with them and you're trying to help solve their problems, it becomes a much better conversation.

It's not like they're just Throw in tickets to the help desk and ticket is never going to get done. I can remember I had been in my health system for so long. The doctors knew my cell phone number, so they wouldn't even go to the, I had been on call, just call me at two o'clock in the morning.

But those are the relationships you build. And I think ultimately what ends up happening is you bring, better products to them and they can bring better products ultimately to the patient and give them, the focus that they need.

Thanks for being on the show today.

I really appreciate it. It's great conversation. As with several of our guests, I feel like I could go on forever talking about some of this stuff, but I really appreciate you being on the show today. And I'm looking forward to seeing you next week. Hope our paths cross.

I will make an effort to find you.

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. [00:17:00] 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.