This transcription is provided by artificial intelligence. We believe in technology but understand that even the smartest robots can sometimes get speech recognition wrong.

I am Bill Russell, creator of this Week Health, where our mission is to transform healthcare, one connection at a time. Let's take a look at what's working today.

 all right. It is our end of year reflection. And I'm looking forward to this conversation with my cohost Sarah Richardson, the lovely Sarah Richardson and the beautiful Drexel Ford. 

Great. See, I told you he's  not just another pretty face.

 Everybody did. You don't know this, but we go through this with Bill all the time, and so it's about half the time today I've been incomparable. Yes. And I think one time I was incomprehensible, that could have been  

better than incompetent. 

That does happen. The incomprehensible happens sometimes, but no, you're, you're a cybersecurity in plain English, so it's hardly ever incomprehensible.  So I do my best. I do my best.  Well, our producer would like us to stay as close to script as we can for this one. And we have already failed miserably, but we are going to do some end of year reflections.

We're gonna start with two questions that the that Holly, our producer gave us to look back on the year. And the first question is, you know, what, what surprised you the most in 2025 as you look at the year? I, you know, I'll, I'll, I'll kick us off. I think the thing for me is, cIO.

Turnover is never a surprise in our industry. But the CIOs that are currently looking or out of work is kind of surprising to me. I mean, these are good quality CIOs. This really reinforces to me that this is a really hard job. Missteps can compound very, very quickly, and these are, I would say, fairly unforgiving times.

You know, most surprising in 2025 is how. Cautious health systems are right now. There's, I, I think there's a little bit too much fear in the industry and really not enough vision and courage in the industry. And, I'm not talking about the, CIO level. I'm talking, I'm talking across the board.

And I think it's causing people to, I don't know create an environment that's not as conducive as we need to in these times where we need to be experimenting and trying things and seeing if we can't break out of our normal rut. So I think that's what surprised me most in 2025 is the, the CIOs that are currently currently looking for a new team. 

and a lot of times it's not your fault. As a CIO who gets displaced. It's not because you did a bad job or you've done something wrong, it's the environment. It's there's been a merger and acquisition or there's been a new CEO that comes in. Who wants new to make a change?  New ceo.

New

CEO is the number one reason.  

Yeah. Yeah, absolutely. So. You know, I know it's hard to say and when, when I talk to many of those folks, I say, don't take it personally. And I know it's hard. That's, you know, it's hard to take. Okay, nice try. I have to take it personally, but sometimes it's not about you at all.

And and sometimes it's the best thing that can happen to you. Look at, look at Bill Russell. It's the best thing that came out. Oh yeah.  

He, he started something new when he left.  Sarah, what surprised you the most in 2025?  

What genuinely surprised me was how fast the workforce sustainability really moved from an HR problem to C-suites, like top strategic priority.

We literally, in almost every dinner and summit went from resilience programs to boards asking, can we still execute our digital roadmap with our workforce? Because consider. The whole wellness program buckets that people have in their health systems. But this year I watched CIOs primarily tell me they couldn't implement either their AI initiatives or bigger upgrades or newer activities because they didn't have staff capacity.

And not because of budget, but because of true exhaustion. People who hadn't taken any of their PTO this year, people who were on these, you know, 10, 12, 16 hour shifts to get certain things implemented. The whole retention became. Not even a, a technology strategy issue. It became more of a, a staffing issue and being able to understand that, you know, finance committees approve.

Projects, but are they also approving a cultural investment that may have gotten laughed at a couple of years ago, but if you can't transform something, 'cause you don't have people that have the capacity to do it, then you run into a sort of implementation crossroads. I mean. We saw during COVID how successful we were at focusing on a few things, and every year the ballooning of the portfolios has created space where people are literally exhausted trying to keep up with the projects, the policies, the budgeting.

I mean, I don't know a lot of happy CIOs right now.

 Drex. I hope you have something a little more uplifting in our reflection for this year. It has been a tough, it has been a tough year. I mean, we,  it's

been a tough year for people.

Yeah.

Either they're outta work or they're exhausted in the jobs that they have.

 You know, so when I think about, what surprised me most in 2025, and I'll talk about this next week in one of the podcasts that I'll do, but I think it's how quickly the synthetic media technology, the AI Advancement soa, and the Deepfake Imaging video stuff. I mean, I think in early 2025, it was kind of mostly a party trick, but it has really moved fast this year.

I mean, even in the last few months it's moved even faster and I feel like that is. The straw that broke the camel's back in. This thing that I'm kind of starting to refer to as a trust recession that we're in. It's not a term that I made up, it's a term that's been around for a while, but I feel like there's a level of noise now all the time.

Everything. I have to be skeptical about everything I see and everything that I read. I can't believe it. And so. Finding those allies that you can count on. Right. Some of the stuff that we're doing, the 2 29 project, finding people you can lean on and learn from and know that they are your allies and they are an anchor of truth for you, turns out to be really important.

And, you know, we're skeptical about all this stuff. The, the level of skepticism has just really kind of continued to surprise me this year. It's gotten higher and higher and higher.

 the good news is. You know, that's what surprised us. So the ne you don't want the positive things to surprise you. The positive things shouldn't surprise you.

The, the negative things sort of surprised us. What did, what did we get right about 2025? What were you looking at that you're like you know what, you know, this is what we thought would happen. And, and this has happened and it's, it's, we're heading in a direction Drex I'll I'll have you start this one off. 

Yeah, sure. I, I think that it would be, it was probably in January. It would be hard to say we knew exactly where the, this was gonna happen, but I think we made a prediction kind of early in 2025 that AI was gonna be a big deal in healthcare. And, you know, maybe we could have sort of put our finger on ambient listening and said, ambient listening is gonna be a big.

Deal in healthcare in 2025. But I think I'm also really surprised by the technology has just advanced so quickly and the entrepreneurs in our space have found really kind of interesting niches that we wouldn't have necessarily called out in early in 2025. Especially for me, the bad guys. The bad guys have done a bunch of really, unfortunately, really innovative stuff with artificial intelligence.

But I think. In the healthcare industry space, we, we knew it would be a big impact. I think we got that right.

 Yeah. The bad guys aren't afraid to fail, are they? I mean, if they fail, they, they pick themselves up. They go on to the next one.  

That's right. That's right. That's all about the money. They don't have to worry about regulation.

They don't have to worry about morals. They just worry about making money. They  

have no guardrails whatsoever. That's right. It's, it's interesting. A lot of innovation has happened in those spaces. O over the years. It's not, this is not a new thing.  They, they lean into it, for sure.  Sarah, what did, what did we get right in 2025?

 Culture as an actual differentiator, not just a conversation about a eating strategy, consider end of last year. I mean, we always said the culture would determine who succeeds the transformation. And this is not about picking an EHR or spending a whole bunch of money on ai. This year we watched it play out in real time.

We have seen organizations with the same technology, same budget, even the same consultants. Have very different outcomes. And the differentiator for that was whether or not the leaders built cultures where people felt safe to experiment, to fail, to challenge each other. We got that right and what we maybe underestimated was how visible it would become.

How important it would be become for retention, for bringing people in for your succession planning. I mean, the recruitment factor alone is people wanna go where really cool things are happening. Because you can't hide cultural debt anymore. I mean, it's, everywhere. And  

cultural debt. Great word.

Yeah.  And if we're gonna keep transforming, then we covered a lot of organizational change management this year, which made me happy too, because transformation demands daily behavior change from everybody in the organization. It's not just an IT initiative anymore. And so hearing all of those and then being able to cover those types of stories in solution showcases with partners was a pretty special thing to see.

 We are heading into my favorite time of the year. I love Hallmark movies. I love the Christmas movies. I know they're predictable. I know what the storyline is like the, from the first three characters you see on the screen. And but, but I sort of love this time. But the one thing I do not like about this time is the articles predicting the, you know, these are the 10 things that are gonna happen in healthcare.

look, you know. Pundit's getting things right is not that hard in this space. You know, for starters, healthcare doesn't move all that fast. Things like, you know, times are gonna be hard, budgets are tight. AI is going to make progress gradually. You know, I just, every time I read one of these, I'm like, nice job Nostradamus.

Like, wow, who would've thought? But you know, the, the thing I will say is that the, the role of the CIO, the expectations. Of the CIO have been elevated. We've been asking for this. I mean, we wanted this, we, we've been saying, oh, we wanna see at the table. It's another way of saying we, we really, we want more responsibility.

We wanna be recognized. And we, we have been, this is good. But you know, they now expect us to be. Digital transformation champions to really understand it people that, that that can change the way that work gets done with the use of technology and, and to make it more meaningful the, the work more impactful and obviously more efficient.

They really expect us to be knowledgeable and be able to apply ai, but, but more than that, to shepherd the organization with regard to the possibilities and the opportunities. Mm-hmm. They expect us, this is the area that I think I'm looking at for next year. They expect us to know the technology as well as the business.

Mm-hmm.

And I think this is gonna be one of the areas that we start to see differentiation in the CIOs. The ones who are willing to really dig in and say, okay, I'm not saying that everybody has to be like, my background is a CTO, so I I rail on this, and people just go to me, oh yeah, you come from CTO background obviously.

But I think when a CIO now is in the room and they're being called on, I think people expect them to have that technology lens and say, Hey, you know what? I think we can apply AI in this space safely. Or I don't think we can, or I think we can, but they have to have an understanding of, of what the transformer models are doing.

Deterministic, non-deterministic. They have to be able to talk that language. It, it's not enough now to say, well, I'm a physician. I know how the EHR works. , It's a more technical world than it was. Just last week.  

They have to know the tech and they have to know the workflow and business, clinical and research operations.

They need to be able to, the good ones, the ones that are gonna be at the top of the heap, are the ones that are gonna be able to figure out how to help their partners, their internal organization partners, their. Peers lead, turn their work through the use of technology. Not just wait to take tickets from their peers, but to actually help their peers figure out what's next.

That's, that's the coolest job ever.  

Yeah. Mm-hmm. Yeah. And, don't, don't hear me saying that. They don't need to understand the, the business. They need to understand the business. They need to understand clinical workflows. And Sarah, I think you've, you've been one who have said, has said this a couple times, that CIOs will make good CEOs because if you understand the business, you understand technology, you understand the clinical side, of course you would. 

And you've already had to deal with difficult customers your entire career. I mean, it is either everyone's favorite or least favorite thing and I don't know, usually it's least favorite. So we already know how to negotiate and influence because of the things we've had to overcome just to get the things in place that people wanted anyway, because you don't just throw the epic bandaid on it and everyone's happy.

I mean, that used to be a win and now it's, it's, that doesn't just get you anything more than what you were supposed to be doing in the first place, kind of reception.  

All right. So I'd, I'd like to transition to sort of personal reflections. We've all done our own individual interviews and city tour dinners, summits, we've all hosted different people along the way.

You know, Drex, I, I'd love to hear your personal reflections. From, from this year.  

Yeah, I think, you know, looking at sort of the shifts, the, some of the shifts that have really not really surprised me, but I think the things that have kind of mattered the most, one of them is taking on resilience.

I think for a long time we really saw chief information security officers and CIOs even who said. And chief technology officers, we are responsible for incident response and disaster recovery. That's our part of this. But business continuity, that's you folks over in clinical operations or business operations.

And the reality is, I think as we've gone through the last couple of years, there's been a lot of. We've gotten better at incident response. We've gotten better at disaster recovery, but business continuity has continued to struggle and somebody ultimately had to jump on the grenade, and I think a lot of CISOs have jumped on that grenade and they've done a really good job of helping to make.

Resilience, this business continuity idea, reality, something that actually is starting to work in some health systems. So I think things like minimum viable hospital and cyber vaults, all this stuff that has kind of gone with that. We've seen a lot of, and partners. Partners doing their part and building systems that have resilience built in.

It's not perfect. We've still got a long way to go, but I think it's been, it's been fun for me to see CISOs. Kind of jump into that part of the business, and it's also really helped them develop this better understanding of everything that happens across the entire organization. It sets them up to become CIOs and chief operating officers and maybe hospital presidents and CEOs someday. 

There's been a real maturing in that group. I mean, I see them at, at the events. That's a, that's a group that's really coming into their own. Sarah,  

I, I seen the partners work with each other. So there's been multiple scenarios where we've had a partner say, and these are the three other partners that round out a perfect or the most perfect version of a security.

Posture that you can have in your organization. And those are often partners that are in our ecosystem. So you don't have to go and hunt and peck on your own and try to Cobb cohesive together. If you have these four solutions, they already work really, really well together. And by the way, here's how we do these things even more effectively.

So when you see the partners starting to. Partner, for lack of a better term, it's take some of the guesswork out of the most critical environments we've ever been in before.  

Hasn't that been fun? I mean, it's actually, it's almost like an unintended side effect of the 2 29 project summits that we've done is that you've seen partners develop relationships that.

Didn't exist. Prior to them coming together and spending time together and kind of going, Hmm, you know, we could do a thing like this. And now you see them running, you know, they're running together all the time. It's been really cool. Unintended consequence.  

Absolutely. Sarah, personal  reflection,

I loved the conversations I had with Eric Linsky and Liz Scott.

I mean, these are women who, through August artists and Alex's Lemonade Stand Foundation have created legacies for their children. And it wasn't, it's not just like how their personal resilience came into play. It's how they channeled grief into changing systems and environments that protect other families and.

Just the true heart by which they show up. Each of them answers, you know, the phone or their organizations that they're willing to partner with, whomever gives. Light to a, a dark situation. I mean, there's a human story driving every single one of the things that they do forward. And probably my two favorite examples were when we were at Bluebird, at Soar, and Erica was there and everyone's drawing pictures all over the hotel windows.

So we got permission to be able to do that. So ev all this conference space is filled with pictures. And then my favorite moment from Liz was me saying, what would Alex want you to do? And she goes, you know, I can't imagine having a 29-year-old daughter right now, but I promise you if she was here, she'd tell me I still need to keep doing some more stuff.

Yeah. But,

It was so important I don't even have kids. And both those stories brought me to tears and that moment in Napa, our last summit of the year when Matt Sullivan's like, we're gonna raise so much money tonight. And we turned. Alex's Lemonade Stand Foundation fundraiser moment, basically into an auction.

He was the barker. We're running around with signs and we, I think we raised like $17,000 in like 20 minutes. So those are just, I love, I love that we get to help other people.  

It's amazing. You killed, you killed us that weekend. We, bill and I were in Lake Oconee and we, we just could not keep up with the CMIO crew out there raising money.

It was, and this is a great, I mean, when we can, when we can do this, if we have sort of like our cross country competitions to raise funds for Alex, it's uh. it's great.  Matt was

selling stuff that Bill hadn't even approved yet. Yeah, right. So I was like, I know it's in the bag.  

Yeah. We've, we, we've gotta get that stuff worked out for next year.

But I'll tell, I mean, we've got a. Bike ride next year, potentially. I mean, there's, there's gonna be people actually on the road and we're talking about how to have people on Pelotons join them and raise money that way. We're gonna do a golf tournament and we're gonna continue to do the things we're doing except with some new stuff.

So, stay tuned. We have a lot, lot of. It's amazing how much time we spend talking about, you would think this is our core business. Like we talk about it all the time. It's like, what are we gonna do? Oh, throw our creativity at it. It's so much fun.  when I think about this year, I think about the, the different conversations  

A couple of interesting things that really got me thinking. One was uh, shakib children's Hospital of Philadelphia. CIO. He he talked about AI ambition. He talked about getting his entire leadership team on board with the, a defining what their AI ambition was as an organization.

He said he started the meeting and he allowed everyone to sort of rate our AI ambition as a, as an organization. And he said it was everything from two to 12. On a scale of one to 10, of course, you know those people who say 12 'cause they're like, we're not going fast enough. Go fast. And and he said,  I don't know anybody like that. 

Yeah. And he just, he just looked at 'em and said, you know, I can't manage the two to 12. Like, we've got a, as a, as a leadership team come up with what we wanna be. And they, they got in a room and they figured out what their AI ambition was. And that's an example of a CIO. You know, taking the lead and saying, look, I, you guys want me to lead out in this?

I'm willing to lead out, but let's, let's determine where we wanna end up. You know, in that same conversation, I thought it was interesting. Chad INE was in that room St. Luke's University Health Network. And it was interesting to hear him talk about not only the platform play, which is really key for a lot of these people with regard to health systems with regard to ai, but it was interesting to talk to him about resurgence in building.

And it wasn't like no code, low code kind of stuff. It was full blown using AI to fill gaps that exist within their health system. And it, it got me to thinking and start asking questions of people. It's like, do you think. Do you think we can rebuild this muscle that we have let atrophy and, and don't have anymore?

Alistair Erskine just blows my mind every time I'm with him. Mike Peffer as well. One of the, one of the cooler conversations this year, Elena said he toured dinner and I followed up with a, an interview was Carla. Carla hack with Emory Chief Financial Informatics Officer. And so brilliant as surgeon.

So brilliant. Her, but her role is to really find the opportunities for the organization. And this is an example to, to find the money that, to essentially they're doing the work already. They just wanna get paid for the work that they're doing. And it, it really, it. It challenged the notion, you know, we we're, we're, we're looking for nickels in our cushions, but not, we not only have nickels in our cushions, we have millions in our cushions as health systems, and she's finding it.

It was such a great interview. Well, she. Blew my mind in the city tour dinner. I'm like, I have to have you on the show. So I had to capture some of that, some of that thinking. And, and it's, it's part technology part really understanding the, the workflow and really understanding. The billing process and, and coding.

I mean, she understands it at a very deep level and focus, you know, we talked about this before, when, when our really smart people can focus for a period of time, they can do some amazing things and she has a focus in that area and has literally found millions of dollars and, in ongoing revenue that they, they capture every year through  

it goes back to that shaki comment right.

About like, I mean, it sort of boils down to we can do anything. We just can't do everything. We have to find focus.  

Yeah,

don't get burn out doing it. Absolutely. We do everything. You will burn out all the time.

 absolutely. Well, this has been a great year and we really appreciate the opportunity to be a part of this community , to bring people together, to have us in the room and be able to be a part of the conversation is,  is really an honor for the three of us. 

And so as we look to next year, you know, here's to more conversations that challenge what we think we know  

more stories that remind us why we do the work,

 and

more courage to protect what matters most.

 Thank you for being a part of this Week, health in 2025. Thanks for listening. That's all for now.

  📍 thanks for watching we believe every healthcare leader needs a community they can lean on and learn from. Discover more solutions and join our community at this week. health.com/subscribe. Share this with someone who could benefit from these insights.

Thanks for listening. That's all for now.