UnHack with Drex DeFord

September 28, 2026: Sarah Richardson with Elbridge Locklear, former CIO and now in the 229 Legacy Program. A finance analyst, knowledgeable in finance, goes out and creates an agent. Elbridge has no knowledge of it. The agent can call other skills, including a way around security restrictions.
86% of leaders say they can govern agents. His question is how, if there is no inventory.
Key Points:
0:00 86% Confident. No Inventory.

0:30 San Diego: Who Owns the AI?

4:15 Cloudticity

6:24 Ping Identity

7:29 Centralization Is Not Standardization

13:34 72% Deployed Without IT Approval

16:11 An Agent IT Never Saw

22:35 Less Owning. Safer Conditions.

LinkedIn: 229Project
Donate: Alex's Lemonade Stand: Foundation for Childhood Cancer

In May, a Tel Aviv company called Irregular was testing Google's Gemini inside a sandbox. A bug left a live internet connection open. The test target shared a name with a real company, and Gemini found it. It guessed passwords until one worked, then used logins sitting in a public repository to get into two more. Three real organizations. The model stopped and backed out. Irregular flagged it to Google in late July. Google notified the three companies and federal authorities, then sat on it for almost seven weeks. The rest of the industry did not hear until the Wall Street Journal asked, and Google confirmed it this month. Google's view: Gemini acted appropriately, stopped itself, and this was not model misalignment, so there was nothing the rest of us needed to know. Jack Cable, a former senior technical advisor at CISA, said those disclosure norms were built for software bugs. A model that stepped outside its bounds and ran real cyber attacks deserves daylight.

In this Two Minute Drill, Drex DeFord asks the question hospitals should put to their vendors now: if an agent wandered into a real system and then stopped itself, would your vendor call you, or would they move on?

Remember, Stay a Little Paranoid.

September 21, 2026: Bill Russell and Sarah Richardson. Dario Amodei wants labs to pace the frontier. The operator version: the more AI you put on an EHR you cannot see, the more it can feel like a denial of service. CIOs at the front of ambient are seeing request volume up 9,000%, because the tool that used to write a note is now pulling the longitudinal record and hitting RevCycle. Sarah's question from New Orleans: how do you even tabletop an agent swarm.

Key Points:

0:00 AI without a view can DOS your EHR

0:21 Newsday open

2:43 Harmony HIT

3:13 Pace the Frontier

7:40 SureTest

8:24 Agent swarms inside a health system

20:20 How do you tabletop a swarm

23:02 EHR load up 9,000%

28:13 Close

LinkedIn: 229Project

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

Army Major Kara Corcoran wears a Ranger tab and two Afghanistan tours. This summer she sat in a separation board five days short of 18 years. The board was not there to weigh her combat record. It was there for one line in her medical record. On July 31, an internal Air Force email said the Secretary of Defense's office had identified service members who may have a current diagnosis or history of, or exhibit symptoms consistent with, gender dysphoria in their electronic healthcare record. The DOD ran a population-wide search of the military EHR, about 9.5 million people, by diagnosis codes, prescriptions, counseling notes, and Tricare-billed civilian care. Over about two months that search outed several hundred active duty and reserve members, academy cadets, and ROTC. One military justice attorney is getting about 25 calls a week from people facing involuntary separation. Data handed over to get care became a target list.

In this Two Minute Drill, Drex DeFord asks the question hospitals should be asking now: who can run a population-wide query by diagnosis code in your shop, and who has to sign off before they do it?

Remember, Stay a Little Paranoid.

September 14, 2026: Bill Russell and Sarah Richardson. The fight is the intelligence layer on top of the EHR. Epic put Art, Emmy, and Penny on the table. ChatGPT already pulled USCDI over FHIR at UCSF. Bill's read: CIOs did not open those APIs. 21st Century Cures did. The loser is the patient portal. He gives it 3 years. Appointments go through the AI. NCH, tiny, is already running a ChatGPT-like persona with nurse triage.
Key Points:
0:00 Patient portals, wiped out in 3 years

0:24 Newsday open

1:48 Who owns the intelligence layer

4:44 Cloudticity

10:54 Portals gone. Patients are in the AI

16:29 No health system on the MCP list

19:32 If tiny NCH can ship it

28:22 Computer use inside Epic

30:22 Close

LinkedIn: 229Project
Donate: Alex's Lemonade Stand: Foundation for Childhood Cancer