The 229 Podcast

Donna Roach, Enterprise CIO for the University of Utah, brings three innovation leaders from University of Utah Health onto the 229Podcast: Reed Barney, Chief Healthcare Data Officer; Shawn Halladay, AI Strategy & Enablement; and Brent Elieson, Technology Innovation. With Bill Russell they map how DEC and TISG set the roadmap, how an AI intake now walks requesters through risk and priority scoring and will not move without an executive sponsor, and how Reed's team ships reusable, AI-ready data products so clinical and AI groups share one foundation.

The stack is getting physical too. After more than $10 million from the Huntsman family for responsible AI at the university level, CEO Dr. Carter King put about $2.5 to $3 million toward a local NVIDIA environment Shawn describes as a token factory for research, operational, and clinical work. One clinical use, Heal at Home early identify, has saved about 70 patient days since inception, and Donna is clear that even the exciting demos still go through governance once they are ready to scale.

Key Points:

0:00 Welcome, Donna Roach

1:29 Meet Brent, Shawn, and Reed

6:00 EHC Consulting

11:11 Making data AI ready

17:44 DEC, TISG, and intake

23:08 Island

24:48 An AI intake that scores itself

28:25 Rackspace

36:44 AI-ready data products

45:15 Local NVIDIA GPUs

52:16 Heal at Home and about 70 patient days

LinkedIn: https://www.linkedin.com/company/229p

Donate: Alex's Lemonade Stand: Foundation for Childhood Cancer

https://www.alexslemonade.org/mypage/3173454

When Marshfield Clinic joined Sanford Health in January 2025, revenue cycle did not wait on the technology. Work queues had sat for a long time, so the combined team blitzed them with extra hands. Roxi Foreman, VP Tech Services at Sanford Health, calls revenue cycle a great example of shared strengths, and she runs governance as a three-footed stool: clinical, revenue cycle, and IT deciding together.

That only holds up on trust. "Every plan is intended to deviate," Roxi said, so her teams review their projects every week, and the measure of trust on a team is whether a leader will admit a goal slipped. A prior auth summit that put clinical, patient access, and tech leaders in one room proved it: "our KPIs came out better and the team came out stronger." Next, she wants patients to book care the way they book everything else, with a text, without working out which specialty they need.

Chapters:

0:00 Welcome, Roxi Foreman

1:50 From integration to shared strengths

3:28 Harmony Healthcare IT

3:59 Revenue cycle did not wait

4:59 Putting people in their strengths

6:24 Governance and the three-footed stool

8:07 Ping Identity

8:36 When the plan deviates

10:34 Trust across the aisle

12:16 Rackspace

13:04 The prior auth summit

15:44 Where patient access needs investment

18:02 Two to three years ahead

20:00 Booking care with a text

22:02 Thank you, Roxi

LinkedIn: https://www.linkedin.com/company/229p

Donate: Alex's Lemonade Stand: Foundation for Childhood Cancer

https://www.alexslemonade.org/mypage/3173454

November 4, 2026: Donald Pollard, Field CTO at SHI, joins Drex DeFord. A health system is told to get AI in and to say what it returns. Donald has three customers in Nashville where two agents stuck in a loop produced a $40,000 bill. A year of budget can be gone in a quarter once the work runs on a meter.

The other half is the work. He wants the hard problem, not an email summary. A forward deployed engineer sits with the person who does the job. His claim: a working system in someone's hands by the fourth day, including at smaller systems. On the bill, an AI router prices a routine question at a nickel per million tokens instead of $50.

Key Points:

• 0:00 Drex and Donald Pollard

• 1:08 End the Shift

• 2:34 Pressured to Put AI In

• 4:33 Two Billion Hours Short

• 5:22 The Hard Problem

• 11:52 Seven Systems, One Patient

• 18:09 Two Agents, a $40,000 Bill

• 19:27 A Nickel or Fifty Dollars

• 20:43 Close

LinkedIn: 229Project

Donate: Alex's Lemonade Stand: Foundation for Childhood Cancer

October 28, 2026: Larger health systems are moving governance, risk and compliance work onto a single platform. Jay Stewart, Chief Revenue Officer at Meditology Services, sees what happens after the move. The platform may solve the problem "80, 85% of the way," and then the team customizes it. "And once you do that, you really start to lose a lot of the efficiency," Jay said.

"The technology is just one piece of that puzzle," he added. Automating without a good foundation does not help, so Jay wants the people and process work nailed down first, and that is where he sees many organizations asking for help. Skip that step, and the team has automated a process it never fixed.

Key Points:

• 00:00 Who Meditology Is

• 01:59 From Imaging Sales to Third-Party Risk

• 03:06 Meditology Services

• 03:31 Budget Scrutiny Reaches the CFO

• 06:21 GRC and the One-Platform Approach

• 07:55 Resilience and Third-Party Risk

• 09:37 Lab Services, Plan B, Plan D

• 11:20 AI Inside the Vendor App

• 13:34 Legislation and HIPAA

• 15:23 Tottenham and Close

Keep up to date on the latest in health IT:

https://thisweekhealth.com/news/

X: This Week Health

LinkedIn: This Week Health

Donate: Alex’s Lemonade Stand: Foundation for Childhood Cancer

October 27, 2026: An application the physicians liked, still on Server 2012 and TLS 1.0, was offline the day after Dan Holland's team priced the risk. Holland, chief information security officer at Tampa General Hospital, had the math: $750,000 of annualized loss against a $100,000 upgrade. "Vulnerability is not a risk," Holland tells Drex DeFord.

Holland used the same math to set tolerance thresholds in Tampa General's risk policy and to inform the insurance limits the hospital doubled this year. Jim Bowie, his predecessor, now at Zscaler, opens the episode and hands Drex the $5 horse question. "You don't want to put a $10 fence around a $5 horse," Holland says. With limited resources, the dollar figure decides where the fence goes.

Key Points:

• 00:06 Jim Bowie

• 07:18 Fortified Health

• 07:51 Dan Holland

• 11:21 Vulnerability Is Not a Risk

• 20:27 Cyber Hero

• 27:46 A $5 Horse

Keep up to date on the latest in health IT:

https://thisweekhealth.com/news/

X: This Week Health

LinkedIn: This Week Health

Donate: Alex’s Lemonade Stand: Foundation for Childhood Cancer

October 22, 2026: Lori Boisjoli has sat at 229 tables as a CIO. Now she is joining 229Project as a Principal, and this conversation with Bill Russell is her welcome to the community. She learned BASIC in high school, took a coding job at IDX in Burlington, Vermont, and soon decided she could not just sit in a cube. She later became CIO of the six-hospital University of Vermont Health system, which went through a cyber attack nearly five years ago. Other CIOs still ask her to share that experience with their executives, sometimes to "scare the hell out of our C-suite."

Now she will host those tables, and she wants each room to leave with more than a takeaway: if a group agrees AI belongs in contract language, she wants that group to propose the language. That instinct goes back to Sharp HealthCare, where she spent the better part of nine months building the hospital side, and the team threw her a baby shower for her firstborn. "It is about the relationships," Lori said. For members, that means a host who was recently in their chair and wants every session to give them something they can use.

Key Points:

LinkedIn: 229Project

Donate: Alex's Lemonade Stand: Foundation for Childhood Cancer

October 15, 2026: The same AI panel opened four 229 Regional Staff Roundtables in September: New Orleans (September 10), Portland (September 15), San Diego (September 17), and Atlanta (September 22). Health system IT leaders on stage. Their teams at the tables. This episode pulls the four rooms together by topic.

Sarah Richardson opens it the way she opened Portland, with the Signal Check the room filled out before it walked in. In Portland, 65% named competing priorities and capacity as the top challenge.

Shane Thielman at Scripps Health went after cost, not revenue. Autonomous coding on emergency department facility coding. About a 50% decrease in the cost per encounter. About 70% coverage in certain areas of that work. It has since moved into professional billing for radiology.

A Piedmont physician built a mock ICU tracker on personal time. Fake patients, a personal AWS server, a GitHub account, so he could show what the tool should look like. He knew the governance. Lacy Knight: "something we can't support today."

Takeaways:

In this episode:

Key Points:

LinkedIn: 229Project

Donate: Alex's Lemonade Stand: Foundation for Childhood Cancer

October 14, 2026: Jim Jacobs, President and CEO at MediQuant, sits with Bill Russell. Cold storage looks cheap until a team has to open the file. The last 3 years of MediQuant's own archive are greater than the previous 20-odd years, back to 1999. Bill asks what it costs a health system to leave an old system running.

Jim has seen the monthly bill go up after too much data moved to the cheap tier. The use case has to be planned before the data moves. Older revenue-cycle data can sit for retention. Imaging, DICOM, and sleep studies are a different cost decision. Leaving an old system on has a second login, a repeated test, and unpatched software when a team stops paying maintenance.

Guest: Jim Jacobs (MediQuant)

Key Points:

LinkedIn: 229Project

Donate: Alex's Lemonade Stand: Foundation for Childhood Cancer

October 8, 2026: Michal Nedoszytko, Member of Clinical Staff at Abridge, sits down with Bill Russell. He is a cardiologist. He practiced in Belgium and Poland for 17 years. As an intern he was making 50 lab sheets a day. He says a PDF generator took that from 25 minutes to about 2 minutes, and the cardiology department started using it. In 2013 the Ministry of Health in Poland required reimbursement amounts on paper prescriptions, from a spreadsheet of about 15,000 medications. He built a site for that. He says about 100,000 doctors a month still use it, almost 15 years later. He says 13,000 people applied to an Anthropic hackathon and he finished third with a post-visit tool he built between patients. He says Abridge shipped real-time voice chart pull about a month before this recording, and he credits Eric Topol with the term Keyboard Liberation. He says the clerical work should leave the visit, and the decision stays with the patient and the doctor.

Key Points:

LinkedIn: 229Project

Donate: Alex's Lemonade Stand: Foundation for Childhood Cancer

October 7, 2026: Yaw Fellin, Senior Vice President and General Manager, Clinical Decision Support and Provider Solutions at Wolters Kluwer Health, sits with Bill Russell. Clinicians used to come to UpToDate for an answer. He is building that evidence into the workflow, including Epic's Art, with 7,500-plus expert contributors behind it. Bill asks what a CIO puts in place so every agent lands on one version of clinical truth.

At Becker's, a clinician using one of the large AI suites thought she knew every medication that patient was on. The system found one in the chart that was not on her radar. She changed the care plan.

Yaw's answer for a CIO is governance first, then room to experiment, as long as the experiments stay safe and get narrowed to the systems that can hold that layer. The closer is cognitive scaffolding: support a resident and a clinician who has been at it for 20 years, and leave the thinking with the person.

Guest: Yaw Fellin (Wolters Kluwer)

Key Points:

LinkedIn: 229Project

Donate: Alex's Lemonade Stand: Foundation for Childhood Cancer