The 229 Podcast

September 16, 2026: Nish Khandwala, Co-Founder and CEO of Bunkerhill Health, and Dr. Peter McCaffrey, Chief Digital and AI Officer at UTMB Health, join Bill Russell. UTMB started with an FDA-cleared incidental coronary artery calcium algorithm. The next question was the workflow: who sees the flag, who acts, do you hire a navigator. Agents now pull the image, the chart context, and the downstream tasks. In 12 months UTMB went from one live agent to 22 on a single instance: missed patients, prior auth, care pathways, referral access.

Key Points:

• 0:00 Open

• 0:06 Solution Showcase

• 0:39 What Bunkerhill is

• 3:10 Incidental calcium, then what

• 5:56 Open systems vs Epic

• 9:10 What's this going to cost

• 11:25 22 agents in 12 months

• 13:29 You can also build expensive RPA

• 16:55 If the agent is a toy

• 20:05 Forward-deployed engineers

• 23:17 Close

LinkedIn: 229Project

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

September 10, 2026: Sherri Hess (former VP and Chief Nursing Informatics Officer, HCA Healthcare) sits down with Sarah Richardson. Not enough nurses on the acute-care floor. Too much admission and discharge work sitting on the people who were already there. Virtual nursing left the first unit in 3 to 4 months. The hard part was adding FTEs, not buying the cart. If you have seen one discharge, you have seen one discharge.

Key Points:

LinkedIn: 229Project

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

September 9, 2026: Russell Teague (Chief Strategist and CISO, Fortified Health Security) sits down with Drex DeFord. Healthcare has been the number-one targeted industry for 13-plus years. Fortified only does healthcare, because no other industry has human life on a 24/7 stack. From there: 40-plus autonomous SOC vendors at Black Hat, a workstation that might be the CT scanner, 97 percent of breaches that never touch the EMR, and a board conversation that has to be about resiliency and patient care, not fear. Zero-day to weaponization is now sub-hour. You will not patch at machine speed.

Guest: Russell Teague (Fortified Health)

Key Points:

• 01:35 Healthcare, Number One for 13 Years

• 05:06 Human in the Loop

• 09:08 97 Percent of Breaches Are Not the EMR

• 13:13 Zero-Day to Weaponization Is Sub-Hour

• 15:47 Talk to the Board About Patient Care

• 17:19 Fear Will Not Win You Money

Bring color and joy to a child’s day: https://augustsartists.networkforgood.com/projects/166901-everyday-giving

Keep up to date on the latest in health IT:

https://thisweekhealth.com/news/

September 3, 2026: Diane Constantine (Children's Hospital of Philadelphia), Cathy Patterson (Banner Health), and Vicki Sergent (Froedtert ThedaCare Health) sit down with Sarah Richardson. If an innovation saves clinician time, prevents harm, and improves the patient experience, but cannot produce a clean 12-month ROI, does it deserve to scale? Cathy's test: if she took it out today, would an outcome change. Vicki's MyChart Bedside was supposed to take a year of phased rollouts. Innovation-unit nurses adopted it hard enough that the system was up in three months. Diane will not manufacture a dollar value for rare pediatric harm. She will measure it.

Key Points:

• 0:00 Does a 12-month ROI decide scale

• 1:30 Name the scorecard

• 6:10 UST

• 6:43 Set the thresholds before go-live

• 11:20 Value that never hits the P&L

• 16:19 Who owns the outcome after go-live

• 21:04 Adoption versus vanity

• 25:58 One decision they would copy

• 31:31 The question for tomorrow's scorecard

LinkedIn: 229Project

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

September 2, 2026: Alan Gabriola (VP of Healthcare, CTG) sits down with Bill Russell. CEOs come home asking why the health system is not doing more with AI. The CIO already knows they can. The shop never finished the hard work underneath. 220 leaders told 229 where next year's money is going: access and revenue cycle. Alan's line for what actually wins: not the most AI. The operating model.

Guest: Alan Gabriola (CTG)

Key Points:

• 0:00 The winners don't have the most AI

• 0:06 Both sides of the table

• 3:13 You cannot sprinkle AI on a messy model

• 7:09 CTG

• 7:50 220 leaders: access and rev cycle

• 10:06 What stalls the work

• 12:52 Governance as differentiation

• 15:16 Why CTG

• 19:05 Speed to outcomes

• 21:06 Close

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

Keep up to date on the latest in health IT:

https://thisweekhealth.com/news/

August 26, 2026: Lindsey Bengfort (Managing Director, Healthcare, NTT Data) sits down with Bill Russell. She buckets what she hears every week into three anxieties: financial, tech/AI, and security. Security used to get skipped in the room. Not now. If you do not have a point of view, you do not get invited. From there: 500 patches on one hospital-critical application, garage-level attackers with open models, and an onslaught of AI features inside the vendors you already own. Lindsey's picture: you keep stacking band-aids. You never stitch the wound. Closes on three places a health system can take cost out without taking it out of patients.

Guest: Lindsey Bengfort (NTT Data)

Key Points:

• 04:48 Three Anxieties

• 08:29 Security Is Table Stakes

• 09:44 500 Patches on One Hospital App

• 10:38 Garage Attacks

• 12:53 Band-Aids on a Cut

• 17:12 Three Ways to Take Cost Out

Bring color and joy to a child’s day: https://augustsartists.networkforgood.com/projects/166901-everyday-giving

Keep up to date on the latest in health IT:

https://thisweekhealth.com/news/

August 24, 2026: Bill Russell, Sarah Richardson, and Drex DeFord debrief Epic UGM from the week they were in the room. Last year was aspirational. This year has a roadmap, and the pace is blistering enough to consume an entire IT shop. Drex's read: a lot of CIOs have already conceded technical innovation to Epic. What is left is implementation, scale, and governance. Sarah's test: distinguish integration from dependency. The constraint is not whether Epic can ship. It is how much you can absorb, what it costs, and whether operations will own the work.

Key Points:

• 00:00 Epic can consume your entire IT shop

• 06:23 Conceding innovation to Epic

• 07:49 The pace is blistering

• 11:14 Rangers, Gold Star, and your career

• 19:45 The dollars are in operations

• 22:01 The CIO role is bifurcating

LinkedIn: 229Project

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

August 17, 2026: Bill Russell, Drex DeFord, and Sarah Richardson come off a road week and into Epic UGM. Ask a shop how many agents they have deployed. They might say 50. An audit turns up 76. Every frontier lab just said their model got out of the sandbox, and health systems are about to invite the same class of software inside the four walls. Pete Marks at Wake Med cut 20 applications, then the inventory went up. Bill's test is older than AI: an electrician wanted a 300-amp service because of square footage. Square footage uses zero amps. A CIO needs enough knowledge to catch a bad answer.

Key Points:

• 00:00 Welcome into the kingdom

• 05:54 Pete Marks cut 20. Then they went up.

• 08:08 Every frontier model got out of the lab

• 13:31 50 agents on paper, 76 on the audit

• 17:30 The electrician and the 300-amp lie

• 19:13 Enough knowledge to catch a bad answer

LinkedIn: 229Project

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

August 10, 2026: Bill Russell and Drex DeFord preview Epic UGM (Sarah is on a plane to Charlottesville). Bill opens with the reframe that sets the lens for the whole episode: don't mistake a single big announcement for the real pace of change — healthcare moves in months and years, not seconds. Then the preview itself: AI and Agent Factory framed around clinician experience, ambient documentation a year after the freeze, the Bridge/Epic interoperability standoff and the 3-year hedge, the entire state of Washington on Epic, pharmacy as Epic's next growth line, and the leadership exodus — including Bill's real odds on Judy Faulkner's succession at UGM.

Key Points:

• 0:00 Healthcare Doesn't Move in Seconds

• 5:23 Sponsor: Cloudticity

• 7:09 Epic vs the Federal Government

• 12:43 The 3-Year Hedge

• 20:32 Epic Leadership Exodus

• 22:48 Judy's Exit, on Bill's Terms

LinkedIn: 229Project

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

August 13, 2026: CT Lin, MD, spent 30 years at UC Health, the last stretch as Chief Medical Information Officer, before stepping into his next chapter as Professor of Medicine at the University of Colorado and first-time author. His new book, “It’s Not About the Tech: From Potholes to Piglets, Real-Life Lessons in Health IT,” argues that health IT success is 80 percent people and 20 percent technology, a lesson he learned by failing loudly and often. Lin tells Sarah Richardson about the radiology order set that accidentally triggered a hospital-wide outbreak of "acromegaly," the identity crisis of losing a CMIO title after three decades, and why governing generative AI will be this era's tragedy of the commons.

Key Points:

• 01:06 Not About Tech

• 06:10 Sharing Failures

• 10:05 Life After CMIO

• 15:35 AI and Governance

• 18:34 PIGs and Farewell

LinkedIn: 229Project

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