Two Agents Stuck in a Loop | Solution Showcase with Donald Pollard

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 Roach1:29 Meet Brent, Shawn, and Reed6:00 EHC Consulting11:11 Making data AI ready17:44 DEC, TISG, and intake23:08 Island24:48 An AI intake that scores itself28:25 Rackspace36:44 AI-ready data products45:15 Local NVIDIA GPUs52:16 Heal at Home and about 70 patient daysLinkedIn: https://www.linkedin.com/company/229pDonate: Alex's Lemonade Stand: Foundation for Childhood Cancerhttps://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 Foreman1:50 From integration to shared strengths3:28 Harmony Healthcare IT3:59 Revenue cycle did not wait4:59 Putting people in their strengths6:24 Governance and the three-footed stool8:07 Ping Identity8:36 When the plan deviates10:34 Trust across the aisle12:16 Rackspace13:04 The prior auth summit15:44 Where patient access needs investment18:02 Two to three years ahead20:00 Booking care with a text22:02 Thank you, RoxiLinkedIn: https://www.linkedin.com/company/229pDonate: Alex's Lemonade Stand: Foundation for Childhood Cancerhttps://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 Pollard1:08 End the Shift2:34 Pressured to Put AI In4:33 Two Billion Hours Short5:22 The Hard Problem11:52 Seven Systems, One Patient18:09 Two Agents, a $40,000 Bill19:27 A Nickel or Fifty Dollars20:43 CloseLinkedIn: 229ProjectDonate: 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 Is01:59 From Imaging Sales to Third-Party Risk03:06 Meditology Services03:31 Budget Scrutiny Reaches the CFO06:21 GRC and the One-Platform Approach07:55 Resilience and Third-Party Risk09:37 Lab Services, Plan B, Plan D11:20 AI Inside the Vendor App13:34 Legislation and HIPAA15:23 Tottenham and CloseKeep up to date on the latest in health IT:https://thisweekhealth.com/news/X: This Week HealthLinkedIn: This Week HealthDonate: 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 Bowie07:18 Fortified Health07:51 Dan Holland11:21 Vulnerability Is Not a Risk20:27 Cyber Hero27:46 A $5 HorseKeep up to date on the latest in health IT:https://thisweekhealth.com/news/X: This Week HealthLinkedIn: This Week HealthDonate: 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: 0:00 Welcome, Lori 1:03 Atlanta and the resilience panel 3:52 Restore by service, not by tier 5:07 Sharing the story with other C-suites 7:01 AI before joining 229Project 9:25 Agents that work while you sleep 11:31 Carve out time for innovation 12:53 From IDX and Allscripts to the provider side 16:27 "It is about the relationships" 19:20 What she hopes to build with members 21:08 Hosting the room 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: Julie Eastman (PeaceHealth) would defend the initiative that gives clinicians more time to be present with their patients, and that gives the evidence the time was truly returned. A lot of the value is still anecdotal. Lisa Johnson (Providence): about five minutes saved per patient contact on the provider side, before the workflow was refined. An operational leader had set aside four to five hours to compare policies. Copilot did it in about 10 minutes. Falyn Curtis (Ochsner Health) turned on Epic's billing assistant and saw fewer calls about bills, and more of those bills paid once patients could ask what the bill was for. Will Landry (FMOL Health) saw the same drop the day they turned it on. He put it at 60% fewer calls on that topic. Glynis Cowart (Woman's Hospital): ambient listening has to be turned off for a phone call, or the conversation lands in the chart. Lacy Knight: the EHR made bad processes obvious, and "AI has done that a hundredfold." The value is in rethinking the work. Drex DeFord: take a train wreck of a process and it becomes a fast and efficient train wreck. Josh Glandorf (UC San Diego Health): the bottleneck is operational transformation time, not IT time, "with much bigger boulders." Bonnie Boles (Tanner Health) will not move a project until an EVP names the top three. Julie Eastman asks why AI is governed separately from the rest of the portfolio. Same tool, different result. Epic chart summarization in ambulatory was not helping at Tanner. Clinicians found it slow, mistrusted a miss, and could not turn it off. Lacy Knight called the same tool a home run at Piedmont. Her first Copilot rollout went the other way: access went to people who do not live in Microsoft tools, and adoption was poor. Will Landry chose not to block ChatGPT, so FMOL could see the traffic, including on guest Wi-Fi. Pete D'Addio (LCMC Health) is watching the token bill. Steve LeBlond (Prisma Health) treats shadow IT as a need IT did not meet. Jeremy Meller (Children's Healthcare of Atlanta) has hired more AI literacy specialists than AI engineers. On ambient listening for nursing, the more experienced nurses are having an easier time, because the tool requires them to talk to the patient. Lisa Johnson: this is the time to double down on clinical informatics. Will Landry is telling FMOL's 250 certified Epic analysts that he will not need 250 people building in Epic three years from now. At-the-elbow support on the floor is the work he tells them will last. John Henderson (Rady Children's Health) spent a Saturday coding a check-in app for a middle school running club, then stopped. He could not support it. The club uses a spreadsheet. Maili Boynay (Legacy Health): start with the people who have to deploy it. They need capacity, and they need to know what is in it for them. In this episode: Sarah Richardson, Principal, 229 Project Julie Eastman, SVP and CIO, PeaceHealth Lisa Johnson, VP, Clinical IT Solution Delivery, Providence Falyn Curtis, VP, IS Clinical Systems, Ochsner Health Will Landry, CIO, Franciscan Missionaries of Our Lady Health System (FMOL Health) Glynis Cowart, SVP and CIO, Woman's Hospital Shane Thielman, Corporate SVP, Chief Information and Digital Officer, Scripps Health Terri Couts, SVP and Chief Information and Digital Officer, Sharp HealthCare Drex DeFord, Principal, 229 Project Lacy Knight, VP and Chief Health Informatics Officer, Piedmont Healthcare Josh Glandorf, CIO, UC San Diego Health Bonnie Boles, SVP and CMIO, Tanner Health Pete D'Addio, CTO and VP, Technology, LCMC Health Steve LeBlond, Chief Information and Digital Officer, Prisma Health John Henderson, Chief Information and Digital Officer, Rady Children's Health Jeremy Meller, CIO, Children's Healthcare of Atlanta Maili Boynay, VP, IS Applications, Legacy Health Bill Russell, Founder and CEO, 229 Project Key Points: 0:00 Four cities, one panel 0:46 One initiative to defend 2:36 Where the value shows up 7:46 The bad process, a hundredfold 11:19 Capacity 16:06 What did not work 18:45 Shadow AI 23:36 The people 28:02 Why these rooms exist 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: 0:00 Margin Pressure on Both Lines 2:46 Not All Data Is Equal 3:25 MediQuant 5:09 Get Out Your Checkbook 9:28 Last 3 Years 11:48 What It Costs to Leave a System On 14:14 Just Turn It Off 16:56 A Good Engagement 19:08 Close 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: 0:00 Doctors who build 2:31 50 sheets a day 5:57 Between the STEMIs 7:33 15,000 medications 9:54 Still used, almost 15 years later 13:31 One hackathon, 13,000 applications 29:36 Keyboard Liberation 32:49 The patient and the note 35:35 The clerical work leaves the visit 37:29 The decision stays human 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: 0:00 7,500+ Experts, One Clinical Truth 1:32 From a Destination to the Workflow 3:54 Wolters Kluwer 4:17 Evidence Inside Art 13:08 How the Clinician Knows 16:45 What a CIO Puts in Place 20:00 Translation in Five Years 22:50 Cognitive Scaffolding 25:17 Close LinkedIn: 229Project Donate: Alex's Lemonade Stand: Foundation for Childhood Cancer