The 229 Podcast

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

October 1, 2026: John McDaniel, CIO at Trinity Health in Minot, North Dakota, sits down with Sarah Richardson. Trinity is the first acute system on Epic Orchard. The region is rural, about a 120-mile radius, and recruiting and educating an implementation team was the hard part. Epic handles the third-party contracts and the upgrades. Discovery replaced an RFP. More than 300 people, about 10 percent of the organization, took part. John says 97.9 percent chose Epic. He also says undercoded care was about $36 million a year. He chairs the AI council and can say no.

Key Points:

0:00 The first acute system on Orchard

4:16 Luma Health

5:32 Epic handles the contracts and the upgrades

7:38 Clearsense

8:26 Discovery instead of an RFP

10:02 A 10-year case approaches a billion dollars

10:29 About $36 million a year undercoded

13:06 Data owners sign off

13:58 The AI council can say no

16:03 $5 to $10 per encounter

19:43 Use the enterprise as an extension of DTG

LinkedIn: 229Project

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